Pericoronitis is a common dental problem in young adults with partial tooth impactions. It is an acute infection causing swelling or inflammation of gums and surrounding soft tissues of a partially erupted tooth. It usually occurs within 15 to 24 years of age as it is when the third molars start erupting. It occurs when the tissue around the wisdom tooth has become inflamed because bacteria have invaded the area. Poor oral hygiene and mechanical trauma on nearby tissue can cause the inflammation of the soft tissue. This soft tissue covering partially impacted tooth is known as operculum. However, it can be impossible to effectively brush the necessary area and prevent this from occurring due to a partially erupted tooth. Chronic pericoronitis may be the etiology for the development of paradental cyst, an inflammatoryodentogenic cyst.
Food impaction and caries (tooth cavity) are also problems associated with third molar pain. The pain caused can be extreme.
Treatment for minor symptoms of pericoronitis (spontaneous pain, localized swelling, purulence/drainage, foul taste) is irrigation. Major symptoms of pericoronitis (difficulty swallowing, enlarged lymph nodes, fever, limited mouth opening, facial cellulitis/infection) are usually treated with antibiotics. In most instances 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 are treated in a hospital and may require intravenous antibiotics and surgery.
The removal of the wisdom tooth (extraction) should occur at a time when the acute phase (or infection) is not present, as extracting this tooth during the time of the acute/painful infection can cause the infection to spread to dangerous area around the throat. Therefore, a dentist will usually clean the area and/or prescribe antibiotics and wait for it to subside until scheduling the extraction of it.
Pericoronitis can be managed with local debridement and warm salt water rinses. It should go away in about one week. However, if the tooth does not completely enter the mouth and food and bacteria keep building up under the gum, pericoronitis will more than likely return.
Pericoronitis does not cause any long-term effects. If the affected tooth is removed or erupts fully into the mouth, the condition cannot return.