Pericoronitis

Question: What is pericoronitis and how is it treated?

Explanation: Pericoronitis is inflammation of the soft tissue overlying a partially erupted tooth, almost always a lower wisdom tooth. Food debris and bacteria accumulate under the gum flap, or operculum, which cannot be cleaned. The flap becomes swollen, red, and painful, and is often traumatised by the opposing upper tooth. Symptoms include localised pain, swelling, bad taste, and trismus. Treatment involves irrigating beneath the flap, meticulous local cleaning, warm salt water rinses, and analgesia. Antibiotics are reserved for spreading infection. Definitive management is usually extraction.

Related Questions:

What is an operculum?

It is the flap of gum partially covering the crown of an erupting tooth. Beneath it lies a warm, moist, anaerobic space that traps food and bacteria and is inaccessible to a toothbrush. It is the anatomical reason pericoronitis occurs and recurs.

Can pericoronitis become dangerous?

Yes. Infection can spread from the pericoronal space into the submasseteric, pterygomandibular, and submandibular spaces, causing severe trismus, difficulty swallowing, and airway compromise. Difficulty breathing or swallowing means immediate emergency department attendance, not a dental appointment.

Is removing the gum flap an alternative to extracting the tooth?

Operculectomy is occasionally performed, but the tissue frequently regrows and the problem returns. It is considered only when the wisdom tooth is likely to erupt into a functional position. In most cases, extracting the tooth is the definitive solution.