Main
- Pericoronitis is inflammation of the tissues around an erupting wisdom tooth, most often the lower one, with pain and swelling of the gum.
- The cause is the gum flap over the crown, where bacteria and food debris accumulate.
- Warning signs: difficulty opening the mouth, difficulty swallowing, a raised temperature — help is needed urgently.
- The condition is managed by a dentist; if eruption is difficult, an oral and maxillofacial surgeon becomes involved.
- Routine dental check-ups help to notice changes before pain and swelling appear.
What is pericoronitis
Pericoronitis is an inflammation of the soft tissues around an erupting tooth, most often a wisdom tooth. It develops when the gum flap over the tooth is traumatised and becomes infected.
What happens in the body
Pericoronitis begins with a gum flap remaining over the erupting tooth, partially covering the crown. Bacteria and food debris accumulate under this flap, and ordinary brushing cannot wash them out. Gradually inflammation arises in the gum fold, and the tissue around the tooth swells, reddens and becomes painful. The person notices that chewing on that side is painful, and the gum prevents the teeth from closing. If the flap is traumatised by hard food, the inflammation intensifies and spreads to neighbouring areas of the gum. The swelling may lift the cheek, and an unpleasant odour and discharge appear between the tooth and the gum. It is enough to have the traumatising edge of the flap removed by a doctor for the inflammation to stop being maintained.
What causes it to develop
- Eruption of a wisdom tooth: the crown presses against the gum and lifts it, leaving a fold where bacteria and food debris are retained.
- Trauma to the gum from hard food: a hard piece presses on the flap during chewing and tears it, opening an entry point for microbes from the oral cavity.
- Poor oral hygiene: plaque at the gum margin accumulates faster, and the brush does not clean the fold over the erupting tooth completely.
- Crowded teeth: neighbouring teeth are close together, access with a brush to the flap is difficult, and food debris is retained there longer than usual.
- Reduced immunity after an illness: the body holds back bacteria in the gum fold less effectively, so the usual microbial load causes inflammation.
Who encounters this more often
This condition is more common in young and middle-aged people whose wisdom teeth are erupting. Lower wisdom teeth erupt later than upper ones and often press against a neighbouring tooth or the bone. If the crown is tilted, the flap over it persists longer, and the fold for bacterial accumulation remains for a long time. In people with crowded teeth, access with a brush to the far area of the jaw is difficult, so plaque is retained there. After an illness or against a background of fatigue, the body's defences weaken, and inflammation in the gum arises more easily. Hard food such as rusks or nuts more often traumatises the flap and triggers an exacerbation. If a wisdom tooth cannot fully erupt for a long time, it is worth showing it to a doctor without waiting for repeated exacerbations.
What symptoms can occur?
Pericoronitis makes itself known through pain and swelling near an erupting tooth, most often in the corner of the lower jaw. It is important to recognise the warning signs in time and to understand when help is needed without delay.
How it is noticed at the very beginning
Pericoronitis begins with discomfort in the far corner of the jaw, where the wisdom tooth is erupting. At first a person feels mild pain when chewing and something like an interfering lump under the gum. The gum in this place reddens and swells, becoming painful when touched with the tongue. Many explain this condition as fatigue, a cold or an accidentally bitten cheek. Gradually the pain intensifies and radiates to the ear, temple or neighbouring teeth. Opening the mouth becomes increasingly difficult, and an unpleasant odour appears in the mouth. If the swelling and pain do not go away within a day or two, it is worth seeing a dentist without waiting until swallowing becomes difficult.
Signs that occur most often
- Pain in the area of the wisdom tooth: aching or throbbing, intensifies when pressing and chewing, makes it hard to eat calmly.
- Swelling and redness of the gum: the tissue around the tooth swells and changes colour, the swelling is visible from outside at the corner of the jaw.
- Difficulty opening the mouth: the muscles near the focus are tense, the mouth does not open fully, this makes it hard to speak and take food.
- Pain when chewing and swallowing: every swallow and movement of the jaw brings unpleasant sensations, because of which a person eats less than usual.
- Bad breath: it persists even after brushing the teeth and signals inflammation in the gum.
- Raised body temperature: general fever indicates that the process has gone beyond the local one, and the visit cannot be postponed.
When to seek help urgently
Examinations and tests
Examination for pericoronitis is built around an inspection of the oral cavity and clarifying methods that help assess the condition of the gum around the tooth. Below is a breakdown of what exactly the doctor does at the appointment, which investigations are prescribed and what each of them shows.
How the examination begins
The examination begins with an inspection of the oral cavity, during which the doctor assesses the condition of the gum around the tooth. The specialist pays attention to swelling, redness and tenderness of the tissues in this area. Then probing of the gum flap is carried out, allowing its condition and depth to be assessed. This sequence is needed because the external signs are visible immediately, while instrumental checking clarifies the picture. To clarify the position of the tooth and rule out complications, radiography may be prescribed. The image shows the position of the tooth and the condition of the surrounding tissues that are not visible on inspection. The examination is completed by an assessment of the general condition, because how the patient feels influences further management. If at the appointment you describe your sensations in words in advance, it will be easier for the doctor to compare them with the results of the examination.
What is prescribed and what it shows
What is worth preparing for the appointment
- Discharge summaries: take previous dentist's reports so that the doctor can see how the situation around this tooth developed.
- Images: bring previous X-rays of the jaw if they have been preserved, this will save you from a repeat investigation.
- Observations: write down when the unpleasant sensations in the tooth appeared and how they changed from day to day.
- Complaints: formulate in your own words what exactly is bothering you now, this will speed up the conversation with the doctor.
- Questions: make a list in advance of what you want to clarify with the specialist so that you do not forget anything at the appointment.
Which doctor should I see?
Pericoronitis is treated by dentists, and in complicated cases an oral and maxillofacial surgeon becomes involved. Below is an outline of who to consult, what happens at the appointment and which part of the result depends on the patient themselves.
Which specialist manages this condition
Pericoronitis is managed by a dentist, and when a tooth has difficulty erupting, help is provided by an oral and maxillofacial surgeon. The doctor examines the gum around the tooth, assesses the swelling and the spread of inflammation to neighbouring tissues. If a relevant specialist is not available nearby, start with an appointment with a dentist at the polyclinic at your place of residence. Such a doctor will determine whether local treatment is sufficient or a referral to a surgeon is needed. With marked swelling of the cheek and pain when swallowing, help is provided in the oral and maxillofacial surgery department. The surgeon becomes involved when the tooth cannot erupt on its own and the risk of repeated inflammation persists. Delaying the visit leads to the inflammation spreading to neighbouring tissues and requiring a more complex intervention.
What the treatment consists of
- Washing the gum hood: the doctor cleans the space under the overhanging gum of accumulations and food debris to remove the source of inflammation.
- Selection of local anti-inflammatory agents: the specialist selects treatment for the gum taking into account the condition of the tissues, in order to reduce swelling and pain in the area of the tooth.
- Antibacterial therapy when indicated: it is prescribed when the inflammation extends beyond the gum and is accompanied by swelling of the cheek or a rise in temperature.
- Tooth extraction when eruption is impossible: if the tooth remains under the gum and again causes inflammation, it is removed to eliminate the cause of recurring exacerbations.
- Follow-up with a dentist: after the treatment provided, it is important to attend check-ups so that the doctor notices repeated inflammation in time and adjusts the approach.
What depends on the patient themselves
The regularity of follow-up with a dentist largely determines how often inflammation around the tooth recurs. If visits are postponed, the exacerbation returns, and the inflammation involves ever new areas of the gum. The patient themselves notices that pain and swelling appear again after a temporary lull, and this is a reason to come for a check-up outside of an exacerbation. Following the doctor's recommendations for oral care reduces the risk that the inflammation will return to its former extent. Refusing visits after the pain subsides leads to the cause remaining, and the exacerbation recurring. At the check-up the doctor assesses the condition of the gum around the tooth and decides whether the follow-up approach needs to be changed. The patient should clarify in advance with the specialist how often to come for check-ups. The practical conclusion is simple: arrange the next visit immediately after the treatment provided, without waiting for a new exacerbation.
What helps prevent an exacerbation?
This section explains what in everyday behaviour reduces the risk of pericoronitis flare-ups. Regular oral care and dental check-ups help to notice the problem before pain and swelling appear.
What to change in your habits
Thorough tooth brushing reduces the build-up of plaque around an erupting wisdom tooth. The soft tissues around it often become inflamed because of food debris that gets trapped under the overhanging hood. Dental floss helps to clean the gaps the brush cannot reach and reduces gum irritation. If a wisdom tooth is erupting with difficulty, the doctor may recommend removing it before inflammation develops. Refusing this measure leaves a focus that flares up with every weakening of the immune system. Smoking and frequent consumption of sweets maintain inflammation and slow down tissue healing. Discuss with your doctor whether a professional cleaning around the problem tooth is needed.
What to keep under control
- Tooth brushing: regular removal of plaque around the wisdom tooth reduces gum irritation and lowers the risk of inflammation.
- Dental floss: cleaning the gaps where the brush cannot reach helps to remove food debris under the hood.
- Dental check-ups: routine visits allow changes in the tissues to be noticed before pain and swelling appear.
- Condition of the wisdom tooth: monitoring how it erupts helps to discuss removal with the doctor in good time.
- General well-being: a cold and overfatigue weaken the defences and increase the likelihood of a flare-up.
How often to see the doctor
Regular visits to the dentist are needed even when the wisdom tooth does not bother you and the gum looks calm. The doctor examines the eruption area and assesses the condition of the hood and the tissues around it. During a routine examination, changes that the person does not feel themselves become noticeable: slight swelling, redness, plaque build-up. This allows removal of the wisdom tooth to be discussed before inflammation develops. If pain, difficulty opening the mouth or swelling of the cheek appears, the visit must not be postponed. People with frequently recurring flare-ups should agree on more frequent check-ups with their doctor. Such monitoring does not replace the prescribed treatment, but it helps to avoid emergency intervention.
What is worth remembering
Pericoronitis does not go away on its own and cannot be treated with home remedies, so it is important to seek help in time. Below are the main conclusions that will help you make the right decision.
Main conclusions
Pericoronitis is an inflammation of the tissues around an erupting tooth, and its course can be either calm or suddenly severe. Your own well-being helps you notice the onset: pain when chewing, swelling of the gum, bad breath and difficulty opening the mouth. If pericoronitis is not treated, the inflammation can spread to neighbouring tissues, and that is already more dangerous than a local process. People with weakened immunity and chronic diseases should be especially careful, as their pericoronitis is more severe. Do not try to endure the pain or dull it with makeshift remedies — this only delays a visit to the doctor. The dentist will determine whether local treatment is enough or a more serious intervention is required. The sooner you see a specialist, the easier the treatment will be and the lower the risk of a repeated exacerbation of pericoronitis.
