What Is Pericoronitis?...

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Medically reviewed by Edmund Khoo, DDSMedically reviewed by Edmund Khoo, DDSPericoronitis is an infection of the gums around one or more teeth that are growing in (erupting). The infection can result from food, plaque, or bacteria becoming trapped in the gums. Pericoronitis usually occurs as wisdom teeth (sometimes called third molars) erupt in adults, but it can also occur when permanent teeth replace baby teeth in children.Wisdom teeth are located farther back in the mouth than the teeth you are born with and are the last teeth to grow in. Most people’s wisdom teeth begin to grow when they are between 17 and 21 years old. Consequently, most cases of pericoronitis occur in people who are in their 20s.Initial symptoms of pericoronitis include redness and swelling in the gums as well as pain when biting down. Symptoms will worsen over time without treatment. Dentists typically treat minor pericoronitis by cleaning the wound, but they may prescribe antibiotics for more serious infections. In some cases, surgery may be necessary.SymptomsPericoronitis can be either acute or chronic. Acute pericoronitis means you have a sudden onset of symptoms of the infection. With chronic pericoronitis, symptoms may be milder but grow over a longer period.Since pericoronitis in adults almost always occurs around a wisdom tooth, you will likely feel the first symptoms toward the back of your mouth. This type of infection usually affects the lower teeth rather than the upper teeth. Symptoms of acute pericoronitis may include:Inflammation of the gums around an erupting toothRedness and swelling of the gums or faceTenderness or discomfort in the gumsPus coming out of the gumsPain when chewing or biting downAs the infection progresses, or with chronic pericoronitis, you may experience more general symptoms as well, including:FeverBad breathSwollen lymph nodes in your neckPain when swallowingChanges to your voiceTrouble opening your jaw all the way (lockjaw)What Causes Pericoronitis?When a wisdom tooth or a permanent tooth in a child begins to grow in, a pocket of tissue forms over the tooth. This pocket can be difficult to clean, and it may begin to trap food or other sources of bacteria. As those bacteria grow, they can form an infection in the gums.Another possible cause of a pericoronitis infection is having an impacted tooth. Impaction is when something is preventing a tooth, usually a wisdom tooth, from growing in all the way. Having a small jaw or overcrowded teeth are two reasons a new tooth may become impacted. An impacted tooth is stuck in the surrounding tissue or bone, making it more likely to trap bacteria that can lead to an infection.Risk FactorsPericoronitis is fairly common among adults who have wisdom teeth, but certain factors may make you more likely to develop the infection, such as:Having wisdom teeth that are currently growing inHaving an impacted toothPracticing poor dental hygieneExperiencing a lack of access to quality dental care due to lower socioeconomic statusHow Is It Diagnosed?If you're experiencing symptoms of pericoronitis or have persistent pain and swelling in your mouth or gums, you should visit a healthcare provider. Typically, this provider would be a dentist or periodontist (gum specialist).Your provider will ask about your symptoms, how much they are affecting your daily life, and how long you have had them. They will also examine the inside of your mouth for signs of infection, such as redness, swelling, or pus.Then, your provider may perform X-rays on the affected teeth to see how they are growing in. X-ray imaging shows the size, location, and direction of teeth underneath the gums. A panoramic X-ray can show the entire mouth in one image.Based on the examination and imaging tests, your provider can make a diagnosis and recommend a treatment plan.TreatmentsThere is no official standard of treatment for pericoronitis. Different dentists or periodontists may suggest different treatments. Treatment recommendations will likely depend on:Whether the pericoronitis is acute or chronicWhether the affected tooth is impactedWhether the tooth is likely to grow in normally or cause further problemsFor mild cases of pericoronitis, your provider may begin by flushing the infected tissue with a sterile saline solution or peroxide to remove debris. They may then choose to perform scaling and root planing on the tooth, which removes the built-up tartar. Removing the source of the bacteria may be enough to allow the body to clear the infection on its own.If your provider is concerned that the pericoronitis infection already has or will spread to other parts of your body, they will likely prescribe antibiotics to clear the infection. Common antibiotics prescribed for pericoronitis include amoxicillin and metronidazole.In some cases, your dentist may refer you to an oral surgeon to perform surgery on the affected tooth or gums. Potential surgeries for pericoronitis include:Tissue removal: The infected tissue covering the erupting tooth will be removed.Pericoronal ostectomy: The bone that is preventing an impacted tooth from erupting will be removed.Extraction: The entire affected tooth will be removed if X-rays show that there is no room for the tooth to fit in the mouth, the tooth is coming in at the wrong angle, or the infection has damaged the tooth. The surgeon might opt to remove a different tooth that is preventing the erupting tooth from coming in properly.How To Prevent PericoronitisThe best way to prevent pericoronitis infections is to practice good dental hygiene. Brushing and flossing regularly helps keep your gums and teeth clean, preventing bacteria and plaque from building up and causing inflammation or infection. It's also important to see your dentist regularly (once or twice a year) for a professional cleaning.Sometimes, you cannot prevent pericoronitis. The anatomy of your jaw or teeth may result in a pocket of tissue you can’t clean yourself. Getting X-rays during your regular dental exam can help your dentist catch early infections and spot possible causes of future infections.ComplicationsSome mild cases of pericoronitis resolve on their own as the affected tooth grows in and you can clean the gums around it more effectively. However, leaving a pericoronitis infection untreated can result in serious complications, such as:Infection that spreads to other parts of the mouth or throatInjury to the nerves in the jawTooth decay in the affected or surrounding teethBone lossUntreated mouth infections also can lead to life-threatening infections such as Ludwig’s angina or sepsis. Ludwig’s angina is a type of cellulitis (deep skin infection) that develops under the tongue and in the neck. This condition can lead to airway blockage, making it hard to breathe. Sepsis is a full-body extreme immune response to an infection that can damage many organs.A Quick ReviewPericoronitis is a common gum infection that typically occurs around erupting teeth, especially wisdom teeth in young adults. Symptoms include redness, swelling, and pain which may get worse without treatment.Treatments include professional cleaning, antibiotics, and surgery for severe cases. Leaving pericoronitis untreated can lead to serious health complications, so it's important to get prompt treatment from a dentist or periodontist.Practicing good oral hygiene and getting regular dental exams can help prevent infections like pericoronitis.Frequently Asked Questions

Will pericoronitis go away on its own?

If the affected tooth grows in correctly and can be cleaned well, pericoronitis may go away as the tissue covering the tooth recedes.However, if the tooth doesn't come in properly, the infected gum flap could remain, leading to chronic pericoronitis. In this case, you'll need antibiotics to clear the infection and prevent it from spreading to other parts of the body.

Can you brush away pericoronitis?

Regular tooth brushing and other good oral hygiene habits can help prevent infections like pericoronitis, but you should seek medical care once pericoronitis develops. Tooth brushing alone will not make a pericoronitis infection go away.

Does salt water get rid of pericoronitis?

For mild cases of pericoronitis, dentists may use a saline solution to clean out infected gum tissue. This may allow the body to clear the existing infection if the tooth grows in normally.However, you should not assume that you can effectively clean the site of the infection yourself with salt water. Always consult a healthcare provider if you suspect you have an infection.

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