Tooth pain is an extremely common presenting complaint in both dental and primary care offices. Usually, underlying inflammation (and often infection) is a main contributor to mouth pain along with a multitude of additional risk factors. Pericoronitis is one common cause of dental pain and inflammation which often requires corrective treatment.
Pericoronitis is an inflammation of the soft tissues near the back teeth (molars) that can occur as wisdom teeth present during a person’s late teens and early twenties. Although most common in adults, there have been cases of pericoronitis in patients of all ages. Children, teens and adults can all present with this condition, but it is most often seen in adults whose wisdom teeth are presenting or when a child’s permanent teeth begin to erupt. Detailed below are some of the most common causes and symptoms of pericoronitis, and an overview of prevention and treatment is also discussed.
Common Presenting Symptoms
Patients with pericoronitis are likely to have acute pain in the oral cavity as the main presenting symptom, usually localized to one area. In addition to localized pain in the mouth, other symptoms include limited movement of the jaw, pain and discomfort with chewing and swallowing, and possible facial edema (swelling). Signs of inflammation observable on physical exam include red, irritated gums and bad breath.
Because pericoronitis is an infection of the mouth, there may be other signs of infection like exudate (pus), and swollen lymph nodes on the side of the face and neck. If the infection is left untreated, a patient may experience systemic signs of infection including malaise and lethargy or extreme tiredness, fever, chills, and a loss of appetite. If a doctor or dentist decides to order laboratory work, they might see leukocytosis, which is a transient increase in the number of white blood cells to help fight the infection.
Causes of Pericoronitis
In addition to the general inflammation of the gums caused by the eruption of wisdom teeth, there are other contributors to the inflammatory milieu. Sub-optimal oral hygiene (brushing and flossing), limited space in the mouth causing tiny food particles remain even after brushing, and the position of the teeth within the oral cavity can all promote an unhealthy environment for bacteria to grow. Also, the presence of extra (supernumerary) teeth can crowd the oral cavity, making inflammatory conditions like pericoronitis more likely to occur.
Prevention and Treatment
It is best to see a dentist early if there is any pain or sign of infection in the oral cavity. Improving oral hygiene is another important preventative step. Brushing twice daily for at least two minutes and flossing everyday helps keep bacteria from being able to gain a foothold in the mouth, ultimately protecting against the main causes of pericoronitis.
Regular dental visits also dramatically improve oral hygiene and dentists also better able to remove wisdom teeth before they become a more serious problem. In the case of acute or urgent pericoronitis, a dentist will recommend complete, definitive treatment by removing extra teeth and treating infection as necessary. Contact your dentist for additional information and treatment options for pericoronitis.