Pericoronitis: understanding and treating this wisdom tooth infection

Pain in the back of the mouth, swollen gums around a wisdom tooth? It could be pericoronitis , a common inflammation but not to be neglected. We explain to you what pericoronitis is, how to identify it, treat it effectively… and above all how to prevent it.

*This article does not in any way replace the advice of your dentist.

This is an inflammation of the gum surrounding a partially erupted wisdom tooth, especially at the bottom of the jaw. This natural “trap” then becomes a real nest for microbes causing pain, redness, swelling and sometimes fever . 🤒

It's a bit like the "crisis" of the third molar: it tries to find a place for itself, but the gum seriously complicates its task.

Pericoronitis does not occur by chance, it is generally linked to several specific factors. Knowing them can often help you take preventive measures.

• Incomplete eruption of the third molar : sometimes, it remains partially hidden under the gum, creating a pocket favorable to bacteria.
  
  

• Accumulation of dental plaque and food residue : this fold of the gum is difficult to clean with a conventional toothbrush, allowing bacteria to settle there without difficulty.
  
  

• Poor oral hygiene : insufficient or poorly done brushing increases the threat of local inflammation.
  
  

• Stress and fatigue : these conditions weaken our immune defenses, making our body more vulnerable to infections, including in the mouth.
  
  

• Occlusion : When the upper tooth bites on the lower inflamed gum, it aggravates the situation and intensifies the pain.

• Abnormal position of the third molar : it grows crooked or is stuck against another, which can prevent normal eruption.

• Adolescents and young adults , between 17 and 25 years old, the age group where wisdom teeth appear.

• Jaws too narrow , not leaving enough space for those molars to align properly.

• Impacted or semi-included molars , that is to say blocked or partially erupted.

• People prone to frequent oral infections , often due to poor hygiene or weakened immunity.

Regular follow-up with the dentist from adolescence often helps prevent these problems before they become painful. 👩‍⚕️

This affliction rarely goes unnoticed, since it manifests itself through a series of easily identifiable symptoms:

• Throbbing pain around the tooth, making chewing difficult.
  
  

• Gums red , swollen and tender, and sometimes even with pus.
  
  

• Bad breath due to bacteria buildup. 🤢
  
  

• Metallic or infected taste in the mouth.
  
  

• Difficulty opening the mouth due to inflammation affecting nearby muscles.

• Fever, fatigue and lymph nodes , or even malaise, indicating spread of infection.

Don't waste time and consult quickly to avoid worsening. Fortunately, this affliction is well known to dentists. 👩‍⚕️

A visual and tactile examination is necessary to check several things:

• The condition of the gums around the molar,

• The possible presence of an inflamed gingival cap ,

• Signs: redness, pus, swelling, bad breath,

• The patient's ability to open the mouth without too much pain (lockjaw) .

The dentist may ask questions like "How long have you had pain?", "Has it been continuous?", or "Have you had a fever, unpleasant taste, or difficulty chewing?" These elements allow us to suspect it.

Sometimes, a panoramic x-ray is performed to visualize the exact position of the third molar and possible complications (cyst, decay, infection, etc.).

Good news: it can be treated well if you act quickly. Treatment depends on the severity, location of the third molar, and frequency of recurrence. Here are some options your dentist might suggest. 👇

This is often the first step in treatment. The goal is to purify the area and remove food remains stuck under the gum cap:

• Gargle with warm salt water : a simple and effective home remedy for cleansing.

• Antiseptic mouthwashes to reduce bacteria.

• Professional dentist cleaning : It can gently lift the cap to clean deeply and remove pus or residue.

And at home, we brush gently with a soft brush, paying particular attention to the tooth... without exerting pressure to avoid further irritation.

If the pain is moderate, painkillers such as paracetamol or ibuprofen are sufficient. In case of more serious inflammation, the dentist will prescribe antibiotics. Medications soothe the attack, but do not solve the problem. This is why a more sustainable solution might be necessary.

When pericoronitis returns or the third molar is poorly positioned, extraction is the solution . It is done under local anesthesia or oral surgery if the tooth is impacted. The dentist waits until the infection is under control to reduce the risks.

Uncapping, or operculectomy, removes the gum cap over the wisdom tooth. It is a quick and painless procedure thanks to local anesthesia, allowing the tooth to be freed, bacteria to be eliminated and the risk of recurrence to be reduced. Young patients sometimes prefer this option if their teeth can position themselves well. Otherwise, extraction is often the best solution.

If treated promptly, the affliction is benign. But if we ignore it or treat it poorly, it can lead to sometimes serious complications.

The infection can spread if we do not intervene: towards the cheek or neck (facial cellulitis), to the jaw muscles (severe lockjaw), to the lymph nodes and the jaw bone (osteitis). In extreme cases, it may require hospitalization. But don't worry, it's rare, it's better to act quickly.

A poorly positioned or blocked molar can put pressure on adjacent teeth. Result ? Caries, inflammation of the periodontium , or even premature loosening of neighboring teeth.

If poorly cared for, it can return at the slightest fatigue or accumulation of bacteria. These repeated inflammatory outbreaks quickly become very uncomfortable and alter the quality of life (diet, sleep, etc.).

Good news: you can completely avoid it, or at least considerably reduce the risk of a crisis. You just need to adopt a few simple actions every day.

This is the best way to protect yourself against inflammatory bacteria:

• Brush your teeth at least twice a day with a soft electric brush .

• Use dental floss or interdental brushes .

• Use antiseptic mouthwashes if necessary.

From adolescence, regular dental follow-up makes it possible to monitor wisdom teeth, detect problems and act before pain arises. A panoramic x-ray around 16-18 years of age is recommended to prevent problems.

Yes, our body is a whole! Stress, fatigue or an unbalanced diet weaken your immune system and make the gums more vulnerable. So, sleep well, eat a balanced diet, drink water and breathe. 🧘‍♂️

A slight swelling, a little discomfort at the back of the mouth... These are often the first signs of pericoronitis . It is better to consult at this stage than to wait for a real crisis.

Pericoronitis is common and painful, but easy to treat if caught in time. Good dental care and appropriate hygiene help prevent crises… and avoid complications.

👉 Watchword: prevention, hygiene, and responsiveness!