Pericoronitis – Infection associated with Wisdom Teeth

What is pericoronitis ?

Pericoronitis ( peri-‘around’,corona-‘crown’,itis-‘inflammation’),also known as operculitis is infection of soft tissue or gum around the crown of tooth or near partially erupted tooth.The soft tissue which is covering the tooth is known as operculum.

How does it form ?

Pericoronitis is caused by accumulation of bacteria food debris beneath the operculum or flap.It is commonly associated with partially erupted wisdom tooth.It is often associated with wisdom tooth erupting period (15-24 yrs).Gum may swell with pain and limited mouth opening can be seen because of it.

Symptoms of pericoronitis

Bad taste in the mouth from exudation of pus.
Bad breath
Pain in the area of back tooth region.
Swelling of gum causes pinching of gum with opposing tooth.
Tenderness, erythema (redness) and Edema (swelling) of the tissues around the involved tooth.
Difficulty in swallowing.
Disturbed sleep.
Fever
Loss of appetite
Difficulty in opening the mouth

Types

Two types

Acute
chronic

Prevention

Prevention of pericoronitis is done bye removing the impacted tooth or by removing small part of operculum which comes between the opposing tooth and impacted tooth.It can also be prevented by maintaining good oral hygiene.

Management

Acute pericoronitis – The area underneath the operculum is gently irrigated to remove debris and inflammatory exudate. Often warm saline is used but other solutions may contain hydrogen peroxide, chlorhexidine or other antiseptics.

Definitive treatment –

Oral hygiene – Pericoronitis can be treated with maintaining good oral hygiene if debris is not much in the coronal region,there is no need of extraction of tooth

Operculectomy – It includes surgical removal of operculum. Remove the part of tissue which is coming to pinch in between the two opposing tooth.

Tooth Extraction- In severe cases where above treatments not works at optimum level,patients are advise for extraction of wisdom tooth.extraction eliminates any further episodes of pericoronitis.

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