Pericoronitis is an inflammatory condition of the gingival tissue surrounding a partially erupted tooth — most commonly the mandibular third molar — caused by bacterial accumulation beneath the overlying gum flap, known as an operculum.
Why It Matters
Pericoronitis is one of the most common reasons young adults seek emergency dental care. When a tooth only partially erupts through the alveolar bone, the overlapping gingival tissue creates a pocket where food debris, bacteria, and plaque accumulate and are difficult to clean. Without timely intervention, a localized infection can spread to adjacent tissues, the floor of the mouth, or deeper fascial spaces, making early recognition essential.
Signs and Symptoms
The presentation of pericoronitis ranges from mild discomfort to severe systemic involvement. Common signs and symptoms include:
- Localized pain and swelling around the affected tooth, often radiating to the ear or throat
- Difficulty opening the mouth (trismus)
- Purulent or unpleasant-tasting discharge from beneath the operculum
- Halitosis and a persistent bad taste
- Fever, malaise, or regional lymphadenopathy in more severe cases
Classification and Treatment
Pericoronitis is classified as either acute — presenting with intense, sudden symptoms — or chronic, in which low-grade inflammation persists with intermittent flare-ups. Acute episodes may resolve temporarily but tend to recur if the underlying cause is not addressed.
Initial management involves thorough irrigation of the pericoronal pocket with saline or chlorhexidine, and systemic antibiotics such as amoxicillin or metronidazole when infection has spread regionally. Analgesics manage pain during the acute phase. Once inflammation subsides, definitive treatment — most often extraction of the partially erupted tooth or, in select cases, operculectomy — prevents recurrence. The surrounding periodontal ligament and adjacent teeth should be assessed, as chronic inflammation can compromise supporting bone and soft tissue over time.
Prompt evaluation and treatment of pericoronitis are essential to contain infection and protect long-term oral health.