Definition, Causes, and Classification

- Pericoronitis is inflammation of the soft tissues surrounding the crown of a partially erupted tooth.
- It is caused by an accumulation of bacteria and debris beneath the operculum.
- Mechanical trauma, such as biting the operculum, can also cause pericoronitis.
- The condition is often associated with partially erupted and impacted mandibular third molars.
- Other causes of similar pain in the third molar region include food impaction, dental caries, and temporomandibular joint disorder.
- Pericoronitis can be classified as chronic or acute.
- Chronic pericoronitis may have mild symptoms and long remissions.
- Acute pericoronitis is associated with severe pain, swelling, and fever.
- It can lead to the formation of a pericoronal abscess.
- In some cases, the infection can spread to other parts of the face or neck.

Signs and Symptoms

- Pain is a common symptom of pericoronitis and can radiate to the ear, throat, and jaw.
- Tenderness, redness, and swelling of the tissues around the affected tooth are observed.
- Halitosis (bad breath) and a sour taste in the mouth can occur.
- Pus may be visible beneath the operculum, especially when pressure is applied.
- Trismus (difficulty opening the mouth), dysphagia (difficulty swallowing), and facial swelling can also occur.

Diagnosis and Similar Causes of Pain

- Diagnosis of pericoronitis involves identifying swelling and tenderness of the operculum and around the wisdom tooth.
- Dull, aching pain can be felt in the face, around the ear, angle of the jaw, and inside the mouth behind the upper wisdom tooth.
- Similar causes of pain include dental caries, food packing between the wisdom tooth and the tooth in front, pain associated with temporomandibular joint disorder and myofascial pain, and rare occurrence of pericoronitis in both lower third molars at the same time.

Treatment and Complications

- Treatment of pericoronitis involves pain management and resolving the inflammation.
- Flushing the debris or infection from the pericoronal tissues can help resolve the inflammation.
- Removing the associated tooth or operculum may be necessary in some cases.
- Improved oral hygiene is important to prevent further episodes of acute pericoronitis.
- Recurrent pericoronitis may require tooth removal.
- Complications of pericoronitis can include the spread of infection to other areas of the face or neck and airway compromise, requiring emergency hospital treatment.

Prevention, Management, Prognosis, and Epidemiology

- Prevention of pericoronitis includes the removal of impacted third molars before they erupt into the mouth and preemptive operculectomy.
- There is controversy over the necessity and timing of removing asymptomatic, disease-free impacted wisdom teeth.
- Management involves the application of pain management gels, improved oral hygiene, and removal of plaque stagnation areas through tooth extraction or gingival resection.
- Acute symptoms of pericoronitis are often treated before addressing the underlying cause.
- Prognosis depends on plaque stagnation area removal, non-impacted tooth eruption, adequate space, and improved oral hygiene.
- Pericoronitis commonly occurs in young adults during wisdom teeth eruption, and the likelihood decreases significantly after the individual reaches their twenties.

Pericoronitis (Wikipedia)

Pericoronitis is inflammation of the soft tissues surrounding the crown of a partially erupted tooth, including the gingiva (gums) and the dental follicle. The soft tissue covering a partially erupted tooth is known as an operculum, an area which can be difficult to access with normal oral hygiene methods. The hyponym operculitis technically refers to inflammation of the operculum alone.

Pericoronitis
Other names	Operculitis
Pericoronitis associated with the lower right third molar (wisdom tooth).
Specialty	Dentistry

Pericoronitis is caused by an accumulation of bacteria and debris beneath the operculum, or by mechanical trauma (e.g. biting the operculum with the opposing tooth). Pericoronitis is often associated with partially erupted and impacted mandibular third molars (lower wisdom teeth), often occurring at the age of wisdom tooth eruption (15-26). Other common causes of similar pain from the third molar region are food impaction causing periodontal pain, pulpitis from dental caries (tooth decay), and acute myofascial pain in temporomandibular joint disorder.

Pericoronitis is classified into chronic and acute. Chronic pericoronitis can present with no or only mild symptoms and long remissions between any escalations to acute pericoronitis. Acute pericoronitis is associated with a wide range of symptoms including severe pain, swelling and fever. Sometimes there is an associated pericoronal abscess (an accumulation of pus). This infection can spread to the cheeks, orbits/periorbits, and other parts of the face or neck, and occasionally can lead to airway compromise (e.g. Ludwig's angina) requiring emergency hospital treatment. The treatment of pericoronitis is through pain management and by resolving the inflammation. The inflammation can be resolved by flushing the debris or infection from the pericoronal tissues or by removing the associated tooth or operculum. Retaining the tooth requires improved oral hygiene in the area to prevent further acute pericoronitis episodes. Tooth removal is often indicated in cases of recurrent pericoronitis. The term is from the Greek peri, "around", Latin corona "crown" and -itis, "inflammation".