Pericoronitis is a common problem in young adults when a tooth is not fully erupted into the mouth yet. The literal definition of pericoronitis is inflammation of the gum around the crown. This condition most of the time is very painful for the patient.
It usually occurs between 17 to 24 years of age, because that is when the third molars normally start erupting. But the doctor sometimes sees older patient with this clinical condition.
A clinical exam can help diagnose pericoronitis. Your dentist will examine your mouth and note your symptoms. The gums around the problem area are likely to be red, swollen or draining pus. Sometimes the inflammation is such that the patient can bite with the upper teeth, the inflamed gum of the lower jaw. The mouth opening may also be limited. An x-ray can also help determine if your third molars are erupting normally or not.
Pericoronitis is one of the common reasons for wisdom teeth removal, which an oral surgeon typically performs.
A piece of gum tissue appears over the biting surface of the tooth, which is very difficult to clean. Debris collects under the flap and, when the debris is not removed, the gum becomes inflamed. The tissue around a wisdom tooth has become infected because bacteria have invaded the area.
In cases of pericoronitis, food or plaque, which is a bacterial formation that remains on teeth after eating, may get caught underneath a flap of gum around the tooth. If it remains there, it can irritate the gum and lead to pericoronitis. If the pericoronitis is severe, the swelling and infection may extend beyond the jaw to the cheeks and neck.
Treatment for minor symptoms of pericoronitis (spontaneous pain, localized swelling, purulence/drainage, foul taste) is irrigation with specific liquid solutions and curettage of the area under local anesthesia. Major symptoms of pericoronitis (difficulty swallowing, enlarged lymph nodes, fever, limited mouth opening, and facial cellulitis/infection) are usually treated with antibiotics prior to the wisdom tooth removal.
Most of the time the symptoms will recur and the only definitive treatment is extraction. If left untreated, however, recurring infections are likely, and the infection can eventually spread to other areas of the mouth. The most severe cases may require intravenous antibiotics and surgery.
If you feel some of the above symptoms, consult your dentist as soon as possible.
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