Pericoronitis: Symptoms, Causes & Treatment

Pericoronitis happens when the gum around your developing wisdom teeth swells or becomes infected. Wisdom teeth are usually the last teeth to grow, after all your other teeth have developed and taken their rightful positions on the gums. When wisdom teeth start developing, there is usually not enough space for them to erupt correctly. They become impacted, resulting in pericoronitis. Common symptoms of this condition include pain, gum or facial swelling, and sometimes fever, especially if the gum becomes infected.

Dentists can diagnose and treat pericoronitis at its onset, before it escalates into a more severe condition. However, you must visit your dentist’s office immediately after experiencing the first symptoms. Treatment options include oral medication, a pericoronitis mouthwash, antibiotics, or surgery, depending on the severity of the condition. A competent dentist will develop a personalized treatment plan tailored to your specific needs.

An Overview of Pericoronitis

When wisdom teeth start developing, they can become impacted due to a lack of sufficient space in the gum for their full development. As the wisdom teeth continue to grow, they can squeeze their way out of the gum, and the surrounding gum tissue can be severely affected. This may result in inflammation, swelling, or infection, depending on the severity of the matter. The inflammation, or pericoronitis, is a painful condition that begins mildly and gradually worsens over time. In addition to pain and swelling, pericoronitis can cause bad breath and facial swelling, especially if left untreated.

You can develop pericoronitis close to one or multiple wisdom teeth. The condition starts when one or more developing teeth become impacted, or partially trapped beneath the gum. Although it most often occurs when wisdom teeth are growing on the lower jaw, it can also affect the gums on the upper jaw. It starts with a tender or inflamed gum tissue and mild pain. As the inflammation extends and the area becomes infected, the pain becomes unbearable.

If your wisdom tooth becomes impacted, a gum flap may form on top of it as the tooth finds its way to the gum surface. The flap, which usually attaches to one part of the tooth crown, can trap food and drinks, encouraging the growth of harmful bacteria. The debris and food trapped beneath the flap can combine with dangerous bacteria, causing an infection in the gum. This is a common condition that can affect anyone, especially when your wisdom teeth are developing. The most affected are adults aged between 20 and 29 years.

Common Symptoms of Pericoronitis

Like other dental and oral conditions, pericoronitis starts mildly and escalates over time. Dentists recommend seeking treatment immediately when you notice the first signs. Some of the signs you should watch out for, especially if your wisdom teeth are already developing, include the following:

• Fever due to an untreated infection
• Severe pain, especially around where the wisdom teeth are developing
• Swelling or redness of the gum tissue
• Drainage or pus at the affected site
• Pain or discomfort when chewing or swallowing
• Lockjaw, or trismus, or difficulty opening the mouth
• Facial swelling, especially on the side of the developing wisdom teeth
• Swollen lymph nodes, especially in the neck

An untreated pericoronitis can become chronic, causing even more severe symptoms. You could experience the following:

• Halitosis, or a constant bad breath that does not go away even after brushing your teeth
• A bad taste in your mouth
• Temporary or mild ache around the back teeth

Although everyone is at risk of pericoronitis, especially when their wisdom teeth are developing, some people are at a higher risk than others. Your risk of this condition increases under the following circumstances:

• When you are in your 20s, since that is the time the wisdom teeth start developing
• Your wisdom teeth have started developing and are not fully erupted
• You are under stress
• Your gum tissue is in excess
• You are expectant
• Your oral hygiene habits are poor

Diagnosis and Treatment for Pericoronitis

Visit your dentist immediately if you experience pain, sensitivity, or swelling in any part of your mouth. There are common symptoms that could indicate a minor or severe dental or oral issue. When you visit your dentist due to pain in or around the area where your wisdom teeth are developing, they will conduct a physical examination to assess the situation.

A physical exam can include a visual inspection of the painful or inflamed area. The dentist will look out for signs of inflammation, including swelling and redness. They will also check for the absence of pus in the gum tissue or around the tooth.

A physical exam can also include gum probing to check for any accumulated food and debris beneath the gum flap. Your dentist will also check for tenderness and pain to determine the severity of the condition. If you are in severe pain, they will recommend an intensive treatment.

An X-ray examination will provide a clearer picture of what exactly is happening, especially underneath the gum tissue. If the dentist diagnoses you with pericoronitis, they will recommend treatment depending on their findings.

An X-ray examination will show the condition of the developing wisdom tooth. If the tooth can fully erupt, the dentist will recommend other treatments that do not involve tooth extraction. However, if the wisdom tooth is impacted and cannot fully erupt, your treatment can include extracting it.

Here are some of the management tips your dentist can recommend in case the condition is mild, or before you receive professional treatment:

• Rinse your mouth several times a day with an antiseptic mouthwash or warm, salty water. This cleans the area and helps prevent the growth of harmful bacteria that can cause oral infections. It can also reduce swelling.
• Over-the-counter pain medication, such as ibuprofen, can help relieve pain and reduce inflammation. These will manage your symptoms before you receive actual treatment.
• Your dentist will remind you to maintain good oral hygiene habits, including brushing and flossing daily, to remove food remains from the mouth. This will discourage the growth of harmful bacteria. They can recommend an oral irrigator to keep the affected area clean.
• Your dentist can advise you to avoid chewing on the affected part of your mouth to prevent further aggravation.
• In the case of facial swelling, a cold compress can provide relief. It can also help with the pain.

How Dentists Treat Pericoronitis

There is no specific treatment for pericoronitis. Dentists employ a customized treatment strategy for each individual, tailored to their particular symptoms and the severity of the inflammation. Here are some management strategies your dentist can consider in your situation:

1. Dental Cleaning

This is a common strategy whereby dentists clean the affected area professionally to remove stuck food, debris, and harmful bacteria that cause inflammation. Dentists use specialized tools and products to ensure that the affected area is thoroughly cleaned, thereby discouraging the further growth of harmful bacteria. The cleaning process entails the dentist irrigating the affected area to remove any debris that may be trapped beneath the flap. This is an effective treatment for mild cases of pericoronitis. However, you need a more extensive treatment strategy for a more severe condition, including pain management and an antibiotic for the infection.

2. The Use of Antibiotics

In some cases, pericoronitis is not diagnosed until the affected area is already infected. In this case, your symptoms will include severe pain, fever, or chills. Treatment with antibiotics typically begins with a dental cleaning to remove debris and bacteria that have become stuck under the flap. An antibiotic will clear the infection for good, and prevent it from spreading to other parts of the mouth or body. You must carefully follow the dentist’s instructions when taking antibiotics for the medication to be effective.

3. Pericoronitis Mouthwash

The dentist can also recommend a pericoronitis mouthwash with which you can rinse your mouth several times a day to clean the affected area. Mouthwashes like these usually contain chlorhexidine, an antiseptic that cleans and disinfects, to destroy the dangerous bacteria in the mouth completely. You can start with a dental wash and then use mouthwash at home. Your dentist will also remind you to maintain good oral hygiene habits to avoid a re-infection.

However, you could experience some side effects when using a pericoronitis mouthwash. Some people complain that the taste in their mouth changes after using it. Other people experience dental staining. These are short-term side effects that will clear with time. Carefully follow the dentist’s instructions for effective results with the mouthwash.

4. The Removal Surgery

Surgery is always the last treatment your dentist will recommend after trying all the other treatments with minimal results. The pericoronitis surgery involves removing the gum flap that traps food, debris, and harmful bacteria. It is a brief procedure that typically takes only a few minutes to complete. However, your dentist will put you under anesthesia to protect you from pain and discomfort during treatment. After administering local anesthesia, your dentist can complete the surgery in a matter of minutes.

Dentists recommend surgery when your pericoronitis keeps recurring, but the wisdom tooth is in a position where it can fully erupt.

5. Wisdom Tooth Extraction Surgery

Remember that most cases of pericoronitis occur during the development of wisdom teeth. When the teeth do not find sufficient space to erupt fully, they become impacted. If you have an impacted wisdom tooth and have developed pericoronitis, your dentist may recommend extracting the wisdom tooth to manage the condition. If the impacted wisdom tooth is not extracted, you will likely experience recurring pericoronitis, which may result in other oral issues.

The extraction surgery is also minor. An oral surgeon will start the treatment by numbing the affected area to protect you from pain. They will then make an incision into the gum and potentially remove the jawbone around it. They can fragment the tooth into pieces for easier removal. Once all the pieces are removed, the surgeon will clean the surgery site and stitch it closed. They will park it with a gauze to stop the bleeding.

Recovery from this surgery typically takes one to two weeks. Your dentist will advise you to eat soft foods and follow the after-care instructions given after surgery to avoid complications.

How To Reduce Your Risk of Pericoronitis

Although this is a prevalent condition, not everyone who has wisdom teeth developing experiences it; it affects some people more than others. Although this is not typically an issue of poor oral hygiene habits, certain habits and strategies can help reduce your risk of developing this condition. They include the following:

• Practicing good oral hygiene habits, including brushing twice daily and flossing every day. This reduces your risk of attack by harmful oral bacteria. [pay more attention to the area where your wisdom teeth are developing.
• Using an antibacterial mouthwash to rinse your mouth at least twice daily to kill harmful bacteria and maintain fresh breath. You can buy one over the counter or obtain a prescription from your dentist.
• Rinse your mouth with warm, salty water at least twice a day if you don't use mouthwash. Pay closer attention to the area around your developing wisdom teeth. This will flush out stuck foods and bacteria, and reduce your risk of inflammation.
• If you are on treatment, follow your dentist’s recommendations. They could recommend avoiding certain foods, like sticky foods, that can become trapped beneath the gum flap and irritate the area further.
• Visiting your dentist’s office regularly for general examinations and professional teeth cleaning. During such visits, your dentist will examine your developing wisdom teeth to identify possible issues early.

Find an Experienced Dentist Near Me

Pericoronitis is a very common condition that mainly affects adults whose wisdom teeth are developing. Although not everyone experiences it in Encino, you are at risk if your wisdom teeth are developing or if you do not practice excellent oral hygiene habits. A skilled dentist can diagnose and recommend the appropriate treatment, tailored to your symptoms and the severity of the condition.

At Lasting Impressions Dental Spa, our team of highly trained and experienced dentists can handle minor and severe cases of this condition. We can conduct a thorough examination of your teeth, gums, and jawbone to rule out other conditions before recommending treatment. Instead of generalized services, our treatment is usually tailored to meet individual needs. Please call us at 818-751-5100 to discuss your needs and our services in more detail.