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Serious Dental Emergencies: Pericoronitis

Aug 17, 2007
If your wisdom teeth are coming in, you may be experiencing the normal discomfort of a new tooth. But if you notice swollen, red, and painful back gums, or a bad taste, pus, or odor in your mouth, or even difficulty opening your mouth wide, you may be suffering from pericoronitis.

What is Pericoronitis?

Pericoronitis is an inflammation of the gum tissues that cover the chewing surface of molars that have not fully come into the mouth. It most often occurs with the wisdom teeth, most commonly the lower wisdom teeth.

What Causes Pericoronitis?

The most common cause of pericoronitis is food, bacteria, or plaque trapped beneath the gum flap. Here's how it happens. Before a molar comes in, gum tissue completely covers the area, but the gum tissue is not attached to the top of the tooth underneath the gum. As the molar begins coming in through the gum, part of the tooth is exposed, but part of it remains covered by a flap of gum tissue. One way to envision this is to consider a blanket, tucked in at the sides and partially covering a bed, with the blanket standing in for the gum tissue and the top of the bed standing for the chewing surface of the tooth. Think how easy it is to slip your hand under the blanket. It's just about that easy for bacteria and tiny particles of food to get trapped under the gum flap. However, it's not easy to clean under the flap with a toothbrush, so infection and inflammation can quickly develop.

In some cases, the condition can be made worse when the upper molar comes through fully before the lower one. If the lower gum flap is inflamed and swollen with pericoronitis, the upper tooth may bite down on the lower gum flap, causing additional irritation and swelling.

Treatment

It's important to treat pericoronitis, not only because it's painful, but because treatment can prevent a more serious infection from spreading to the neck and cheeks. First, your dentist need to make sure that pericoronitis is what's causing your discomfort. To do that, your dentist will perform a thorough examination. The exam may include probing the gum around the affected tooth and taking x-rays.
If your dentist find pericoronitis, he or she will treat it by thoroughly removing plaque and bacteria from the affected tooth and rinsing around and under the gum flap. To prevent pericoronitis from reoccurring, your dentist may, depending on the circumstances, surgically remove or reshape the gum around the tooth or extract the tooth.

Your dentist will also advise you about taking care of the area at home. Homecare may include rinsing your mouth with warm salt water (about 1 Tbs. salt per glass of warm water) or an antimicrobial mouthwash. Your dentist may also suggest that you use an oral irrigator to soothe the area and help keep the area bacteria-free. In some cases, your dentist may also prescribe antibiotics.

Pericoronitis is painful and can lead to more serious problems, but be assured that it can be treated and your pain-free smile restored.
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