Pericoronitis: A short guide

You’ve woken up one morning and the back of your mouth feels all swollen. In fact, every time you bite down, the gum in that area seems to feel that something is hidden inside it and its hurting pretty badly. Rinsing your mouth out with salt water seems to help but after a few hours, the pain and swelling seems to have gotten worse. You know you don’t have a cavity and there is nothing in that area that could have caused the problem. Of course, you are just 23-years-of-age and you don’t think that you have any dental problems. What could be the cause of so much pain?

You have Dental Pericoronitis!

You’ve woken up one morning and the back of your mouth feels all swollen. In fact, every time you bite down, the gum in that area seems to feel that something is hidden inside it and its hurting pretty badly. Rinsing your mouth out with salt water seems to help but after a few hours, the pain and swelling seems to have gotten worse. You know you don’t have a cavity and there is nothing in that area that could have caused the problem. Of course, you are just 23-years-of-age and you don’t think that you have any dental problems. What could be the cause of so much pain?

Signs and Symptoms

As the name suggest, pericoronitis refers to an inflammation that has occurred around an erupting tooth or partially erupted tooth. This is usually seen in wisdom teeth that erupt anytime from 20 to 40 years of age. Not everyone gets wisdom teeth but some patients have a genetic predisposition to the teeth. For them, the teeth will try to push themselves into the oral cavity depending on a preset genetic trigger. Unfortunately, by the time the teeth erupt, there is no space for wisdom teeth in the oral cavity. As a result, the patient will frequently experience bouts of discomfort as the extra tooth tries to push itself into the mouth. Pericoronitis occurs when the wisdom tooth manages to push itself partially out of the bone and gum and then is stuck, neither in nor out. The partially erupted tooth usually covered with a flap of freely moving gum tissue that protects it as it erupts into the mouth. As the patient eats food, extra food particles are stuck under the gum flap and they ferment and infect the gum tissue, resulting in a gum infection called as pericoronitis. However, the problem is a recurrent condition. As the gum flap is in place, food particles can be stuck at any time causing recurrent infections. This is referred to as chronic pericoronitis

Oral Examination

The most signs and symptoms of pericoronitis are pain, infection, fever, body ache, and difficulty in opening the mouth, foul odor in the mouth, foul oral taste, and swellings in the lymph nodes of the neck. A few patients may experience malaise and facial swelling, and painful swallowing as well. For some patients, the infection may spread rapidly and it may move down and out to the gums, cheek and neck causing a serious oro-facial infection.

Treatment

If pericoronitis is limited to the tooth, the patient will be treated with antibiotics to control the infection and painkillers to relieve the pain. Other supplementary measures like warm saline rinses and hydrogen peroxide rinses are also effective in controlling the pain and swelling. Patients should not place hot or cold compresses on the cheek surface as this may increase the size of the swelling.

If the condition recurs, the dentist may recommend removal of the gum flap that is causing the problem. In case of serious infections, the wisdom tooth may be removed. Preventive care in the form of improved oral hygiene measure, intradental flossing, fluoridated mouthwashes and regular dental checks ups are recommended.