Pericoronitis And Wisdom Teeth Infection: Causes, Symptoms, And Treatment

Discomfort in the back of your mouth isn’t always just caused by cavities. It may be due to pericoronitis, which is a painful bacterial infection around a partially erupted tooth. Pericoronitis is mostly caused by wisdom teeth infection during their eruption in patients between the ages of 17 and 25, with approximately 80% of cases involving lower third molars. Responsible for 10-15% dental emergencies, dangerous pericoronitis symptoms, such as pus formation under the gum flap (dental abscess), require urgent treatment. Early pericoronitis treatment prevents life-threatening spread of infection and conditions that compromise the airway/breathing (i.e. Ludwig's angina, sepsis). When treated promptly, 90% of cases resolve with conservative treatments like irrigation, antibiotics, or simple flap removal (operculectomy). Contact Great Lakes Family Dental Group for professional intervention within 24 to 48 hours of a pericoronitis flare-up.

What Is Pericoronitis?

What is pericoronitis? Understanding the pericoronitis definition can help you identify its warning signs and symptoms so they can be addressed early before causing serious complications. Pericoronitis is a painful gum infection around a partially erupted tooth. Symptoms typically begin when third molars erupt into the mouth (80% of cases from lower wisdom teeth) between the ages of 17 and mid to late twenties. During tooth eruption, a gum flap (operculum) may develop, which can trap food particles and bacteria underneath and cause pain, swelling, and infection. Urgent treatment is crucial to prevent serious complications like dental abscess formation and the systemic spread of infection.

Common Causes Of Pericoronitis

There are several possible causes of pericoronitis, of which the most common include:

Partially erupted wisdom teeth: Wisdom teeth pericoronitis accounts for 90% of cases and is most prominent in young adults in their teens to mid/late twenties. Wisdom teeth primarily become stuck underneath the gums and bone (impacted) during their eruption due to a lack of spacing within the jaws.
Food debris/plaque accumulation: Gum flaps easily trap food, debris, and dental plaque, allowing bacteria to thrive. Bacteria buildup triggers inflammation and issues, including pericoronitis.
Poor oral hygiene around molars: Maintaining excellent oral hygiene is crucial to prevent pericoronitis. Molars, located toward the back of the mouth, can be challenging to reach with a toothbrush and floss, which makes them increasingly vulnerable to infection.
Weakened immune system: Factors such as medical conditions, fatigue, and stress can weaken the immune system and make bacterial infections like pericoronitis and other illnesses harder to manage.
Recent dental work irritation: Dental procedures may cause localized gum tissue inflammation. Without proper oral hygiene and professional management, the inflammation can worsen and lead to infection.
Trauma to the gum tissue: Injury to the gums, such as from chewing or eating hard foods, can trigger inflammation and dental issues like pericoronitis.

Types Of Pericoronitis

Various types of pericoronitis exist, often categorized by duration, severity, and location. Mild symptoms of pericoronitis should be reported to your dentist promptly, but may be professionally monitored until more permanent treatment is recommended. In contrast, spontaneous pain, swelling, and other moderate to severe pericoronitis signs and symptoms should be addressed by your dentist urgently. Pericoronitis is treatable no matter the severity, but it can leave lasting damage and become life-threatening if not treated early.

Duration:

Acute Pericoronitis: Presents as sudden onset inflammation surrounding a partially erupted tooth. Common symptoms include severe pain, swelling, difficulty opening the mouth, and pus discharge.
Chronic Pericoronitis: Defined as long-term inflammation of the gums around a partially erupted tooth. Signs and symptoms resemble acute pericoronitis and frequently recur over time without permanent treatment.

Severity:

Mild Pericoronitis: Early-stage pericoronitis signs and symptoms include mild gum swelling, pain, or tenderness surrounding the affected tooth.
Moderate to Severe Pericoronitis: Common signs and symptoms include severe pain, pus discharge due to abscess formation, abnormal breath or taste in the mouth, jaw/facial swelling, fever, and difficulty breathing or opening the mouth.

Tooth Location:

Transient Pericoronitis: This condition occurs as teeth are erupting into the mouth, which causes temporary inflammation that goes away once the tooth is in its correct position.
Non-Transient Pericoronitis: When a tooth does not erupt into its proper position and becomes partially or fully trapped underneath the gums (impacted), non-transient pericoronitis may occur.

Symptoms And Warning Signs of Pericoronitis

Pericoronitis symptoms and signs should be evaluated urgently to prevent infection from becoming severe and spreading to the jaws/neck. Wisdom teeth infection signs often become noticeable during their eruption around ages 18 to 25 due to a lack of jaw space for them. Here are common signs and symptoms to watch out for and report immediately:

Early symptoms:

Tooth sensitivity
Visible gum pocket
Red, swollen gum flap (operculum)
bad breath and/or taste in the mouth

Emergency symptoms:

Severe throbbing pain near the wisdom teeth
Difficulty opening mouth (trismus)
Jaw stiffness
Swollen lymph nodes/facial swelling
Fever
Headache
Pus discharge (abscess formation)
Pain when swallowing/chewing

Why Pericoronitis Requires Urgent Treatment?

Pericoronitis infection should not be ignored, as it can quickly escalate and cause permanent damage to your health. As bacteria multiply and spread into the jaws, neck, bloodstream, and other areas of the body, severe life-threatening airway and respiratory pericoronitis complications may occur, including Ludwig's angina and sepsis. Other common untreated pericoronitis risks include severe pain, jaw stiffness, adjacent tooth damage, dental abscess, fever, and chronic gum disease. Once signs and symptoms of infection are present, patients often have only a 24 to 48-hour treatment window to prevent hospitalization. It’s important to seek immediate professional evaluation, which not only can help you avoid tooth extraction but also save your life.

What To Do Immediately For Pericoronitis?

For immediate relief from pericoronitis, it’s crucial to contact your dental professional right away. While preparing to see your dentist, perform pericoronitis first aid to help temporarily manage your symptoms. Beneficial pericoronitis home treatment involves using a cold compress on the affected area and rinsing your mouth thoroughly with warm saltwater every 4 hours to help reduce swelling. For pain management, ask your healthcare provider about OTC pain relievers before using, such as Ibuprofen (i.e., 600 mg every 6 hours). Implement a soft foods diet, avoiding chewing in the affected area, and gently clean the area with a soft toothbrush after meals. Avoid consuming hard, sticky, acidic, or spicy foods or poking the gum flap, which can cause irritation and worsen inflammation. Do not attempt to make an incision on the gum flap at home, as this can lead to serious health consequences.

How Dentists Diagnose Pericoronitis?

Pericoronitis diagnosis begins with a clinical examination and a thorough review of your medical history and current symptoms. Your dentist will check for visual signs, including swelling, gum flaps, partially erupted teeth, bleeding, and pus discharge. They may also gently probe your gum pocket to check for trapped food/debris and infection. A pericoronitis x-ray helps identify the angle and position of the tooth (dental impaction pattern), the health of the surrounding jawbone, and issues like decay, cracks, or an abscess.

Your dentist will distinguish pericoronitis, characterized by inflammation surrounding a partially erupted tooth, from other possible diagnoses like periodontitis and abscess using all the diagnostic information taken. A dental abscess is identified as a localized collection of pus in a pimple-like bump on the gums. Whereas, periodontitis is a severe form of gum disease that affects the tooth-supporting structures of multiple teeth. Rapid diagnosis of early pericoronitis allows dentists to manage mild to moderate cases conservatively with non-surgical treatment options. If pericoronitis becomes severe or chronic, surgical treatment may be necessary.

Pericoronitis Treatment Options

Pericoronitis treatment varies based on factors like the severity of the infection and the frequency of recurrence. Mild to moderate cases of pericoronitis are often managed with conservative professional dental care along with at-home management. Professional irrigation and dental cleaning of the affected area is commonly recommended to remove bacterial plaque and debris from within the gum flap. Your dentist may also prescribe pericoronitis antibiotics and/or antiseptic rinses like chlorhexidine to reduce bacteria and swelling. At home, warm saltwater rinses, cold compresses, and OTC medications like ibuprofen or Tylenol may be recommended.

More definitive treatment is needed for severe cases of pericoronitis. Dentists may recommend an operculectomy, a minor surgical procedure to remove the gum flap covering a partially erupted tooth. Wisdom teeth removal or extraction of the affected tooth becomes a last resort to reliably and permanently eliminate pericoronitis.

Pericoronitis In Children Vs Adults

There are unique differences between adult and pediatric pericoronitis. Pericoronitis in children is uncommon but may occur during the eruption of permanent teeth, primarily the first and second molars. Symptoms may resemble those that occur during teething, making early dental evaluation important to properly diagnose and manage the condition. Dentists may recommend conservative monitoring until all permanent teeth have erupted into the mouth. In cases of severe infection, children may be prescribed antibiotics. Antibiotic dosages for children and adults differ, as child dosing is almost always factored by age and weight.

Pericoronitis in young adults and adults usually peaks around ages 18 to 25 when third molars (wisdom teeth) erupt into the mouth. Other common causes include poor oral hygiene and delayed tooth eruption. Symptoms for adults tend to progress faster than in children and may be more intense. While conservative approaches like oral hygiene improvement and antibiotics may be recommended for mild to moderate cases of pericoronitis in adults, tooth extraction may be necessary if experiencing severe symptoms. Regardless of age, severe pericoronitis can become life-threatening if not treated promptly.

Preventing Pericoronitis Recurrence

Pericoronitis prevention heavily depends on maintaining diligent oral hygiene. Adequate brushing and flossing are necessary to remove food debris and plaque from each tooth, including wisdom teeth at the back of the mouth that can be challenging to reach. Using fluoride toothpaste, a water flosser, and a soft-bristled electric toothbrush is recommended to assist in reducing bacteria buildup. Warm saltwater rinses are also beneficial in reducing inflammation and bacterial buildup.

It is crucial to visit your dentist for regular checkups, which involve detecting dental issues early and performing essential treatments like fluoride varnish, sealants, and professional cleanings. Wisdom teeth typically begin to erupt around age 16 to 18, when wisdom teeth monitoring is particularly important. For patients with anatomical high-risk factors for pericoronitis recurrence, such as a deep gum flap (operculum) or unfavorable tooth position, tooth extraction is often the most reliable permanent solution for pericoronitis prevention.

When To Seek Emergency Care For Pericoronitis?

Do not ignore the danger of pericoronitis swelling, which is life-threatening. A pericoronitis emergency should be addressed immediately by a medical professional to avoid infection from spreading and causing systemic health consequences. Seek emergency dental care or go directly to the ER if after hours and experiencing any of these red flags:

Severe pain
Difficulty breathing, swallowing, or opening your mouth
Lockjaw (trismus)
Severe gum, jaw, face, or neck swelling
Fever >101°or chills
Pus drainage
Pimple on the gums (dental abscess)
Persistent bad breath or taste
Rapid heart rate
Mental confusion

How Great Lakes Family Dental Group Can Help With Pericoronitis?

Great Lakes Family Dental Group's pericoronitis treatment is pain-free and will effectively eliminate your symptoms. Our expert dental providers are equipped for same-day pericoronitis irrigation, antibiotics, laser operculectomy, and emergency wisdom teeth extraction, among other personalized treatment options to protect your overall health. Using modern low-radiation digital X-rays/panoramics, non-invasive techniques, and rigorous infection control protocols, Great Lakes Family Dental Group ensures your visits are safe, comfortable, and highly effective. Contact one of our convenient Great Lakes Family Dental Group Locations to schedule your visit.

Frequently Asked Questions

Will pericoronitis go away on its own?

Pericoronitis requires dental treatment to fully resolve and prevent infection from worsening. Pericoronitis is characterized by gum inflammation around a partially erupted tooth. Partially erupted teeth are challenging to clean, leading to trapped food debris and bacteria that promote dental infection. If left untreated, infection can spread to other areas of the body and cause severe health issues.

How long does pericoronitis pain last?

Pericoronitis is typically a recurrent issue with symptoms that come and go until the issue is treated professionally. Pain usually lasts a few days to several weeks during each flare-up. Improving oral hygiene and warm saltwater rinses may provide temporary relief, but it is important to seek dental evaluation to permanently eliminate symptoms.

Can pericoronitis spread to my cheek/jaw?

Untreated pericoronitis can spread to your cheek, jaw, and other areas of your body. Common alarming signs and symptoms of infection spreading include facial swelling, severe pain, fever, and difficulty chewing, speaking, or breathing, which requires immediate emergency care. Do not wait to seek medical treatment if experiencing any of these signs and symptoms, as untreated infections can become life-threatening.

Do I always need antibiotics for pericoronitis?

No, antibiotics are not always needed to treat pericoronitis. There are several treatment options for pericoronitis, and each patient’s treatment plan is personalized based on factors like the severity of their symptoms, the position of the affected tooth, and your dental and overall health. Antibiotics may be recommended for severe cases of pericoronitis with accompanying treatments like minor gum flap surgery (operculectomy) and tooth extraction.

When should wisdom teeth be removed for pericoronitis?

Your dentist may recommend that wisdom teeth be extracted for pericoronitis based on the severity of your symptoms. Wisdom teeth are often removed if they are causing you to experience severe pain, infection, facial swelling, or difficulty chewing, speaking, or breathing. Wisdom teeth may also be removed if they are the underlying cause of pericoronitis and cause recurrent infections.

Is pericoronitis contagious?

No, pericoronitis is not contagious. It develops when food particles and bacteria become lodged under gum tissue around a partially erupted tooth, which leads to inflammation and infection. The infection can spread within your own body if untreated and cause serious issues. If you suspect you have pericoronitis, schedule a visit with your dentist right away for treatment.

Can pericoronitis cause lockjaw?

Lockjaw is a common complication of pericoronitis. Pericoronitis is an inflammatory condition around a partially erupted tooth that can lead to infection that spreads to your jaw muscles and other areas of the body if not treated promptly. This can cause painful muscle spasms and difficulty opening your mouth, affecting your ability to chew and speak properly.

How do dentists remove the infected gum flap?

Dentists may recommend an operculectomy, which is a procedure that treats pericoronitis by removing an infected gum flap (operculum) covering a partially erupted tooth. This helps prevent food debris and bacteria that trigger inflammation from becoming trapped underneath the flap. The procedure is quick, gentle, and uses local anesthesia for patient comfort. There are a variety of methods that may be used to remove the infected gum flap, including a surgical scalpel, dental laser, or electrocautery tool.

Will pericoronitis return after treatment?

Pericoronitis can return after temporary treatments like antibiotics, deep cleanings, and infected gum flap removal (operculectomy). Inflammation may come and go as bacteria and food debris become trapped under the gums of partially erupted teeth. Gum tissue even has the tendency to grow back over time when removed with operculectomy treatment. Permanent treatments like the extraction of the partially erupted tooth typically address the underlying cause of infection, which rarely returns.

Does pericoronitis require wisdom tooth extraction?

Pericoronitis does not always require a wisdom tooth extraction. However, if the infection is recurrent or the wisdom tooth is causing other issues due to its position, extraction may be the best treatment option. If pericoronitis is causing mild symptoms for the first time, your dentist may initially recommend continued monitoring in combination with temporary treatment options like antibiotics, a deep cleaning, or a gum flap removal procedure (operculectomy).