What are the risks of untreated pericoronitis? (photo)

Doctor's Answers 2

Photo of Dr Elvin Leong
Dr Elvin Leong

Dentist, Prosthodontist

Pericoronitis is defined as inflammation of the gum tissues surrounding the crown portion of teeth that have not completely emerged (partially erupted) into the mouth. This condition occurs mostly with the third molar teeth, also known popularly as the wisdom teeth.

When the gum flap covers the partially erupted tooth, there is a tendency for food and bacteria to be trapped under the gum flap, and there is difficulty in cleaning under the gum flap, and this usually and inevitably leads to inflammation and ultimately, infection.

It is important to address pericoronitis promptly. At its mildest form, there is a feeling of low grade pain, swelling and a bad odour coming from the infected area. At times, there could be some resolution of the inflammation before it reaches full blown infection, but almost always, the condition will recur. It also does not help that the upper opposing tooth continuously bites down and irritates the gum flap.

As pericoronitis becomes more severe, the infection can spread from the affected area to the cheeks and neck. There may be greater amount of swelling, which in turn leads to difficulty in opening the mouth (a condition called trismus), and associated fever, discharge of pus, pain on swallowing and lymph node swelling. In rare cases, complications of pericoronitis can be life-threatening. This occurs when the infection spreads under the jaw and tongue, leading to neck pain and breathing problems due to obstruction of the airway. This dangerous condition is known as Ludwig's Angina. There is also the possibility that the infection can spread into the bloodstream, in a condition known as sepsis, which can also be life-threatening.

It is crucial that symptoms of pericoronitis are treated swiftly to keep the infection from spreading and to lessen the risks of complications.

Anyone experiencing symptoms of pericoronitis should contact their dentist as soon as possible.

First of all, with pericoronitis, you are going to experience pain and swelling. What makes it worse is that you may accidentally bite on the swollen soft tissue, further traumatising the gum. You are expected to have difficulty in eating for that few days.

Untreated pericoronitis may give rise to systemic symptom such as fever and malaise. Untreated dental infection may also lead to cellulitis, characterised by facial swelling. In rare occasion, dental infection may be life-threatening if the swelling of soft tissue causes blockage of the airway.

More often than not, you may find pericoronitis resolves on it’s own. However, due to the orientation of the wisdom tooth, it will recur.

It is always advisable to remove wisdom earlier rather than later due to the fact that at younger age, the root may be shorter (due to incomplete root formation) and the bone may be softer. Hence, the extraction may be less traumatic which translates into less post op pain.

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Answered By

Dr Eng Cern Gan

ENT Doctor

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