Question: How is an infected wisdom tooth managed?
Explanation: Management depends on severity. Localised pericoronitis is treated by irrigating beneath the gum flap, thorough local cleaning, warm salt water rinses, and analgesia. Antibiotics are added if the infection is spreading, if there is significant trismus, or if there is systemic upset. Definitive treatment for recurrent infections is extraction, or occasionally coronectomy where the roots lie against the inferior alveolar nerve. Severe infection with trismus, difficulty swallowing, or airway compromise requires hospital admission, intravenous antibiotics, and surgical drainage under general anaesthetic.
Related Questions:
What is a coronectomy?
A procedure removing the crown of a lower wisdom tooth while deliberately leaving the roots in place, used when the roots are intimately related to the inferior alveolar nerve. It substantially reduces the risk of permanent lip numbness. The retained roots usually remain symptom-free and slowly migrate away from the nerve.
When does a wisdom tooth infection need hospital treatment?
When there is difficulty swallowing or breathing, an altered voice, swelling crossing the midline beneath the chin, trismus limiting opening to less than two fingers, or systemic sepsis. These indicate spread into deep neck spaces and require intravenous antibiotics and surgical drainage.
Can I keep an infected wisdom tooth if the infection settles?
Sometimes, if it is likely to erupt fully into a functional position and the episode was isolated. Recurrent pericoronitis, decay, or an impaction that damages the second molar generally leads to extraction. Repeated infections carry cumulative risk.
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