What is Pericoronitis?
Pericoronitis is an inflammatory condition of the operculum or gum flap around a partially erupted/impacted tooth.
It is common around the lower last molars or wisdom teeth. Upper canine may also be affected.
Classification of Pericoronitis
Pericoronitis can be classified into:
- Subacute
- Acute
- Chronic
- Acute-on-chronic
Causes of Pericoronitis
- Mixed microbial infection
- Food impaction and plaque accumulation under gum flap
- Trauma to gum flap from opposing tooth
- Ulcerative gingivitis
- Reduced resistance
- Anaerobes in plaque
Symptoms and clinical features of Pericoronitis
- Soreness and tenderness around partially erupted tooth
- Pain
- Swelling
- Enlargement of regional lymph nodes
- Fever
- Abscess formation
Investigations
- Radiographs
- To establish the position of the affected tooth and its relationship to the second molar
- This may show impacted third molar
Treatment for Pericoronitis
Non-drug treatment
- When mouth opening is possible: careful irrigation under the gum flap to clear debris, using warm saline mouthwash
- To be done frequently until stagnation area is removed
- Operculectomy
- Disimpaction of the third molar by surgical extraction
- Occlusal reduction of opposing tooth
- Extraction of opposing tooth to forestall supraeruption and sequelae
Drug treatment
- Appropriate antibiotics
- Analgesics
- Supportive therapy
Possible complications of Pericoronitis
- Cellulitis
- Ludwig’s angina
- Osteomyelitis
- Submasseteric abscess
- Temporomandibular joint ankylosis