Pericoronitis: Symptoms, Causes and Treatments
Long and incorrect eruption of wisdom teeth provokes trauma to the gum tissue, resulting in an inflammatory process – pericoronitis.
As a wisdom tooth begins to erupt, it encounters several obstacles, including bone, periosteum, and gum soft tissue. With a long complex process, a kind of gingival hood is formed, under which pathogenic bacteria and food debris can fall. All this can lead to inflammation in the gums. In addition, some other factors can aggravate the pathological condition and accelerate the development of the disease. Complications such as gingival hyperplasia, malocclusion, or deviation from the correct anatomical shape of the tooth can contribute to the development of the inflammatory process.
Depending on the symptoms and complications, there are two main types of pericoronitis wisdom tooth:
- The acute stage occurs in 60-70% of cases of lower molars eruption and represents the initial form of pathology. The characteristic signs of this condition are the abrupt onset of the disease, a pronounced pain syndrome, and the presence of discharge from the gums. With proper treatment, the symptoms disappear in 3-5 days. Acute pericoronitis is also divided into several forms such as catarrhal, ulcerative, and purulent.
- Chronic pericoronitis develops gradually and can last for months or even years. It is characterized by a slow course of the inflammatory process, periodic symptoms, tooth decay, as well as the development of inflammation in the soft tissues of the oral cavity.
If the patient wants to stop the disease in time, it is important to contact a specialist at the first sign. In this case, the dentist can prescribe an effective treatment that will help reduce inflammation, pain and avoid the development of complications.
This pathology is quite common and easy to notice. Most often, this develops during the eruption of third molars (wisdom teeth). Pericoronitis symptoms begin with the formation of a gum hood that puts pressure on the tooth as it erupts. Then there is redness and swelling, which is accompanied by pain. At this stage, it is advisable to contact the dental clinic for additional diagnostics. During the examination, the specialist will determine the stage of development of the pathology and prescribe treatment. If the patient does not contact the dentist in time, the condition may worsen.
In addition to the appearance of a gum hood, other signs indicate the development of the disease:
- bad breath;
- the feeling of a bitter or purulent taste;
- loosening of the tooth;
- swelling and redness of the gums;
- the occurrence of severe pain, including when chewing;
- the spread of pain radiating to the ear and temple;
- difficulty in swallowing;
- enlarged lymph nodes;
- restriction of mouth opening due to edema.
It is a misconception that pericoronitis can go away on its own. Symptoms may subside after a while, but this is a sign that the disease has passed into the chronic stage. This is fraught with such serious complications as osteomyelitis, mobility of neighboring teeth, abscess, the appearance of cysts, and ulcerative stomatitis.
As the teeth erupt, the tooth rests against the mucous membrane and cannot always overcome such an obstacle. Consequently, it continues to grow under the gingival hood, gradually lifting and injuring the gum. This leads to the accumulation of pathogenic bacteria and food particles in the tooth tissue. Unfortunately, it’s impossible to carry out thorough hygiene under the gingival hood, which often leads to the appearance and development of pathology.
In addition, there are some other pericoronitis causes that can aggravate the course of the disease:
- chronic diseases of the oral cavity – erosion and ulcers, stomatitis, caries, and periodontitis, including near an erupting tooth;
- lack of proper hygiene;
- anatomical features of the structure of bone tissue and gums;
- thyroid pathology;
- bone injuries in jaws;
- genetic factors (predisposition to pericoronitis);
- weak immunity;
Many patients also make the mistake of brushing their teeth too thoroughly during the eruption. However, this approach is not entirely correct. The fact is that during this period the gum becomes very sensitive and hard movements of the toothbrush can injure it. Therefore, it is worth giving preference to regular rinsing with antiseptics and anesthetic liquids.
Depending on how serious a case is, dentists use different treatment options that can provide relief:
- Medication therapy. If the disease is at an early stage and has no complications, the dentist may recommend pericoronitis treatment at home. To do this, it is important to maintain good oral hygiene using a soft toothbrush and irrigator. It is also recommended to rinse your teeth with salted warm water to reduce inflammation. As an additional solution, other antibacterial fluids can also be used to reduce bacteria in the mouth. While these steps may help relieve symptoms during teething for a while, it is essential to seek medical attention if your health worsens.
- The incision of the gingival hood. In most cases, for high-quality therapy, dentists use surgical intervention. This method is used for recurrent exacerbations, severe pain, and also in the case of purulent pericoronitis. Surgical pericoronitis treatment is performed under local anesthesia, so the procedure will not cause pain. An obligatory step is washing the mucosa with antiseptic solutions. This method will allow you to qualitatively clean the area of the tooth eruption from food debris, preventing the development of the inflammatory process in the tissues. Excision of the hood can also be done with a laser, which significantly reduces the risk of inflammatory complications. It also minimizes secondary infection of the wound and the likelihood of bleeding. After the procedure, the recovery period is much shorter, and the patient does not need to additionally treat the excision area.
- Wisdom tooth removal. As a rule, such teeth have no practical value, as they grow in adulthood when the dentition is fully formed. Therefore, the decision to keep it or remove it is entirely individual. If this molar is not damaged by caries and grows in the right direction, then it can be left. In case of complications, this tooth will be removed. The dentist chooses the extraction method based on the overall clinical picture and other complicating factors. After anesthesia, forceps or other instruments are used to remove the molar, depending on the complexity of the situation.
Medical postoperative therapy includes rinsing with antiseptic and antibacterial fluids, as well as the use of painkillers. In addition, the dentist recommends avoiding excessive physical activity for several days, as well as giving up irritating foods (hot, spicy foods). The recovery period usually takes a few days.
The process of growing a wisdom tooth can be quite complex and cause various problems. Therefore, to avoid complications, it is necessary to visit the dentist regularly and detect pericoronitis in advance – inflammatory process that often occurs. Only timely treatment guarantees the preservation of dental health and the avoidance of unpleasant consequences.