A 29-year-old breastfeeding mother came to the clinic presenting with recurrent severe pain near her back teeth and diffuse facial swelling. On intraoral examination, there is redness and swelling of the gum surrounding the impacted lower third molar teeth. Periapical radiographs were taken. A diagnosis of Pericoronitis was made. Surgical extractions of the lower third molars were carried out.

 

What Is Pericoronitis?

Pericoronitis is the inflammation of the tissue surrounding a third molar, otherwise known as a wisdom tooth. It most often occurs in partially impacted (not fully visible) third molars. It’s also more common in lower molars than in the upper ones.

 

How Does Pericoronitis Affect My Oral Health?

Most people with pericoronitis have a flap, called an operculum of gum tissue partially covering the crown of the erupting impacted molar tooth. Food, bacteria, and debris can get trapped underneath the operculum and cause infection. This results in the following signs and symptoms:

– Severe toothache and headache

– Fever

– Redness and swelling of the gum tissue

– Pain while swallowing

– Trismus (lockjaw)

– Pus discharge

– Facial swelling

– Bad breath

– Bad taste

 

How Common Is It and Who Does It Affect?

It is most common in people aged 20 to 29 and it affects all sexes equally.

 

What Are the Causes and Risk Factors of Pericoronitis?

– Age between 20 & 29

– Impacted wisdom teeth

– Poor oral hygiene

– Fatigue and emotional stress

– Sugary and sticky food

– Hormonal imbalance in pregnancy and breastfeeding women

 

Can Pericoronitis Be Life-Threatening If Left Untreated?

Yes, a person experiencing pericoronitis can develop a life-threatening complication called Ludwig’s angina, in which the infection spreads into the head and neck. The infection can spread to the bloodstream, otherwise known as sepsis, and is also a rare, life-threatening complication.

 

Is Pericoronitis Contagious?

No.

 

How Is Pericoronitis Diagnosed?

Your dentist will ask about how you feel, then examine your wisdom teeth and the gum tissue covering the teeth. A dental X-rays would be taken to check the state and health of your teeth roots to rule out other causes of pain, such as cavities.

 

How Do You Treat Pericoronitis?

Your dentist will consider several factors when deciding how to treat your pericoronitis. The three treatment options are:

– managing or alleviating the pain near the third molar (wisdom tooth)

– removing the flap covering the tooth (pericoronal flap gingivectomy)

– removing the wisdom tooth (Surgical extraction)

 

What Is the Outlook for Pericoronitis?

Once the wisdom tooth has been removed, pericoronitis rarely reoccur. In cases where a flap of gum tissue is removed, the tissue can sometimes grow back.

 

Preemptive care and regular dental visits can lessen your chances of this condition.