Pericoronitis: causes, symptoms, and treatment for wisdom teeth

A pericoronal abscess is an infection that forms around a wisdom tooth, also called the third molar, that hasn't fully come through. This often happens when the tooth doesn't have enough room to come through properly. As a result, a small gum flap covers part of the tooth and encourages bacteria to build up.

Pericoronitis, on the other hand, refers to gum inflammation around the tooth. But if this inflammation progresses into a bacterial infection, it's then called a pericoronal abscess. In short, the abscess is the most advanced and most painful stage.

You usually feel it at the back of the mouth, often around the third molar. It can be throbbing, like pulses, and spread to the ear, throat, or jaw. Eating then becomes really uncomfortable.

The gum around the tooth changes appearance: it becomes red, swollen, sensitive, and it hurts to the touch. Sometimes a small "flap" can also partially cover the tooth.

There can be a whitish or yellowish gum fluid that oozes out. This is a typical sign of a bacterial infection, not very pleasant to see but important to spot.

The inflammation can affect the jaw muscles, which makes opening the mouth harder. This discomfort can make eating and speaking difficult.

Poor oral hygiene habits can easily lead to gum recession. By that, we mean occasional or overly aggressive brushing. This also shows up through eating foods that can cause tooth hypersensitivity. As a result, plaque forms. Without proper treatment, it turns into tartar by feeding on the bacteria present in the mouth. 😷 These are the precursors to cavities and gum recession. Many other factors, such as smoking, can also cause gum recession.

The bacteria responsible for the infection often cause bad breath and an unpleasant taste that lingers.

In more serious cases, the condition can cause general fatigue, fever, tender lymph nodes under the jaw, as well as a feeling of malaise throughout the body.

Often, these teeth don't have enough room to come through properly. They then stay partly stuck, creating an area that's hard to clean.

Small food particles and bacteria easily build up in the gum flap around the tooth. This bacterial buildup then leads to infection.

If you don't clean the back of your mouth well, bacteria take the opportunity to grow around the third molars.

Certain factors increase the risk of developing a pericoronal abscess: smoking, stress, fatigue, a weakened immune system, poorly positioned wisdom teeth.

Here are the profiles most often affected by this type of abscess:

• Young adults, especially between 18 and 30,

• Those whose third molars have only partially come through,

• People with a narrow jaw,

• Those who have trouble brushing well all the way at the back.

The problems can sometimes come back several times as long as the tooth stays in a problematic position.

While waiting to see your dentist, here are a few tips:

• Brush your teeth gently but thoroughly,

• Use mouthwashes, antiseptic ones, as your dentist recommended,

• Avoid foods that are too hot or that could irritate the area,

• Eat softer foods instead,

• Drink enough water.

And above all, never try to pop the abscess yourself.

It all depends on how serious it is; the dentist may suggest:

• A thorough cleaning of the area,

• Draining the pus,

• Antiseptic mouthwashes,

• Painkillers to ease the pain,

• Antibiotics if needed.

Antibiotics aren't automatic: it mainly depends on how extensive the abscess is.

If infections come back often or the tooth is poorly positioned, the dentist will often recommend removing the tooth to prevent it from happening again.

If left untreated, a pericoronal abscess can last several days, or even several weeks.

With the right care, though, symptoms generally improve within 48 to 72 hours. After that, full healing depends on a few things:

1. How serious the condition is
2. The treatment carried out
3. Whether or not the third molar needs to be removed.

Here are the signs that should really alert you and prompt an urgent appointment:

• Visible swelling of the face,

• A high fever,

• Difficulty swallowing,

• Trouble breathing,

• An oral environment that doesn't open properly,

• Pain so intense that not even medication helps.

To limit the risks, it's essential to have a flawless oral hygiene routine. That means thorough brushing twice a day, without forgetting the hard-to-reach spots. If needed, you can use interdental brushes, and remember to change your toothbrush regularly.

Regular check-ups with the dentist help track how these teeth are coming in and anticipate any potential complications.

If left untreated, things can quickly take a turn for the worse. The problem can spread to nearby tissue, forming a deeper abscess, or even cause facial cellulitis. In serious cases, eating or speaking becomes really difficult, and there's even a risk of a generalized infection.

Many patients say the pain set in slowly and became truly unbearable within a few days.

The most common situations are when:

• A third molar has only come through halfway,

• The gum swells up regularly,

• It hurts when eating,

• The mouth has trouble opening.

And in most cases, once the tooth is removed, the problem is resolved for good.

A pericoronal abscess is a common condition that develops around the wisdom teeth when they haven't fully come through. It generally shows up as:

• Severe pain,

• Gum swelling,

• Sometimes some pus oozing out,

• Difficulty opening the mouth.

If you see a professional quickly, this will let you:

• Ease the pain,

• Prevent it from getting worse,

• Start the right treatment,

• Find out whether or not the wisdom tooth needs to be removed.