Pericoronitis

At Kansas City Urgent Dental, many patients call the office who aren’t sure if their dental condition is considered an “emergency,” and so they ask us when they call whether or not they need to be seen immediately by a dentist, or whether they can wait a few days to get into their normal dentist.  One such emergency is what we call in the profession, pericoronitis, an infection of the gum tissue surrounding a wisdom tooth that is in the process of erupting into the mouth, or is partially erupted in the mouth but no longer erupting. Pericoronitis is a dental condition not generally well known by the general public, but it is potentially serious. it is important to understand the causes, symptoms and treatment options associated with pericoronitis.

What is Pericoronitis?

According to the United States National Institute of Health, pericoronitis is a localized, intraoral soft tissue infection commonly associated with erupting lower third molars. As a wisdom tooth erupts and begins to poke through the gum soft tissue, the tooth is exposed to bacteria from the mouth. Typically the erupting tooth is surrounded by gum tissue with only a small connection which is open to the mouth and the plethora of beneficial and harmful bacteria living in the human mouth. This cocoon surrounded by gum tissue where the wisdom tooth resides in the mouth is nearly impossible to clean with a toothbrush, thus creating the ideal warm and wet environment for bacteria to flourish and causes an infection. To make matters worse, once the area becomes inflamed, upon biting, the upper wisdom tooth may smash this inflamed tissue resulting in ulcerations and increased pain. Yikes!

What causes Pericoronitis?

This sometimes severe infection usually manifests with a bottom wisdom tooth (#17 or #32) which is in the process of erupting into the mouth. Commonly the tooth is partially impacted, meaning there isn’t enough space in the mouth for the tooth to fully come in, so it remains partially erupted. What occurs is that a flap of gum tissue covers the tooth, allowing food remnants, plaque, and bacteria to infiltrate the area causing infection.

Common causes of Pericoronitis.

• Incompletely erupted wisdom teeth: Occurs when there is inadequate space for a 3^rd molar to properly erupt into the mouth.

• Lackluster oral hygiene:  It’s important to keep the area surrounding a partially erupted tooth clean and free of debris to minimize the risk of infection.

• Trauma or injury: Any type of trauma or injury inflicting the gum around the partially erupted tooth can increase the risk of infection.

• Medical conditions affecting the entire body: Systemic medical conditions such as diabetes or other autoimmune diseases may increase the likelihood a patient will develop an infection, including pericornitis.

  
  

Pericoronitis Symptoms

A patient with pericornitis may experience a variety of symptoms ranging from mild discomfort to severe pain and swelling. It’s important to pay attention to any changes in your mouth that could indicate this condition. Typical symptoms may include:

• Pain or soreness around the affected tooth

• Gingival swelling and the affected tooth

• Redness and inflammation in the area surrounding the tooth

• Trouble opening the mouth all of the way (trismus)

• Foul breath (halitosis) or a bad taste in the mouth

• Exudate or discharge from the area

• Fever

• Swollen lymph nodes

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How is Pericoronitis Diagnosed?

An emergency dentist can usually diagnose pericoronitis based on your symptoms and a thorough comprehensive oral examination. In most cases, X-rays will be taken to check for any underlying dental issues, such as impacted wisdom teeth, which could be contributing to the condition. A complete dental examination helps the emergency dentist determine the best course of treatment.

Treatment for Pericoronitis

The treatment for pericoronitis depends on the severity of the condition. In most cases, it can be managed effectively with the following methods:

1. Improved Oral Hygiene

   • Professional cleaning: Your dentist may clean the area to remove any trapped food particles, plaque, or bacteria.

   • Home care: After professional cleaning, maintaining good oral hygiene at home is essential. Regular brushing and flossing, along with using an antibacterial mouthwash, can help prevent further infection.

2. Antibiotics

   • If the infection is bacterial, your dentist may prescribe antibiotics to help control the infection and reduce inflammation. Antibiotics can prevent the infection from spreading and alleviate symptoms.

3. Pain Relief

   • Over-the-counter pain medications, such as ibuprofen or acetaminophen, can help relieve discomfort and reduce swelling. Warm saltwater rinses can also be soothing and help keep the area clean.

4. Surgical Treatment

   • In many cases or when pericoronitis keeps recurring, your dentist may recommend surgical removal of the gum tissue (or "flap") covering the tooth. This can help prevent the area from becoming trapped with bacteria.

   • Tooth extraction may be necessary if the wisdom tooth is impacted, causing chronic issues. Removing the tooth can help prevent future episodes of pericoronitis.

     
     

Preventing Pericoronitis

While some factors (like the size of your mouth or the position of your wisdom teeth) are out of your control, there are ways you can reduce your risk of developing pericoronitis:

• Practice good oral hygiene: Brush your teeth twice a day and floss regularly. Make sure to clean the area around partially erupted teeth to remove food particles and bacteria.

• Rinse with saltwater: Regular saltwater rinses can help reduce bacteria in your mouth and soothe irritated gums.

• Regular dental checkups: Keep up with your routine dental appointments. Your dentist can monitor your wisdom teeth and catch any early signs of pericoronitis before it becomes a more serious problem.

• Consider tooth extraction: If you have impacted wisdom teeth, your dentist might recommend removing them before they cause problems.

Conclusion

An infection caused by pericoronitis is a potentially serious medical conditions which can in rare cases spread to other parts of the head and neck region, potentially creating more serious consequences.  It’s important to recognize the symptoms of a tooth or mouth infection as soon as possible so you can contact an Kansas City emergency dentist. At South Kansas City Emergency Dental we treat patients with pericoronitis and other dental conditions. Call us at 816-601-1817 to schedule an appointment to be seen for your dental emergency.