YOUR wisdom teeth (third molars) usually start to enter your mouth during late adolescence. Sometimes, there’s not enough room for them and they come in partially or not at all. This condition can lead to pericoronitis — inflammation of the tissue surrounding the tooth.

When only part of the tooth has erupted into the mouth, it can create a flap of gum tissue that easily holds food particles and debris and is a hotbed for bacteria. Pericoronitis can also occur around a wisdom tooth that has not erupted at all and is still under the gums.

SYMPTOMS OF PERICORONITIS

Symptoms include: Painful, swollen gum tissue in the area of the affected tooth, which can make it difficult to bite down comfortably without catching the swollen tissue between your teeth; a bad smell or taste in the mouth; discharge of pus from the gum near the tooth; swollen lymph nodes under your chin (the submandibular nodes); muscle spasms in the jaw; swelling on the affected side of the face.

Pericoronitis is diagnosed during a clinical exam. Your dentist will see inflamed gum tissue in the area of the unerupted or partially erupted wisdom tooth. The gums may be red, swollen or draining fluid or pus.

Pericoronitis can be managed with antibiotics and warm salt water rinses; the condition should go away in approximately one week. However, if the partially erupted tooth fails to completely enter the mouth and food debris and bacteria continue to accumulate under the flap of gums, pericoronitis will more than likely return.

PREVENTION

You can help to prevent pericoronitis by practising good oral hygiene on any erupting wisdom tooth to make sure that food particles and bacteria do not accumulate under the gums. However, if these steps do not work and pericoronitis returns, it may be necessary to have the overlying flap of gum tissue removed. In some cases, the wisdom tooth may need to be extracted.

TREATMENT

Pericoronitis can be tricky to treat because the flap of gum tissue won’t go away until the wisdom tooth emerges naturally or until the tissue is removed.

Your dentist will clean the area thoroughly to remove damaged tissue or pus. If the area is infected, you’ll be given oral antibiotics.

Your dentist will give you instructions for keeping the area clean, which is the best way to prevent the problem from returning. This usually involves brushing and flossing daily, and rinsing your mouth with water several times a day. This will help prevent food particles from accumulating in the area.

In some cases, your dentist may suggest you have your tooth extracted once pericoronitis is under control. If your dentist thinks the tooth may erupt fully into the mouth without problems, he or she may leave it alone. However, if pericoronitis recurs, the tooth may be extracted.

Pericoronitis that causes symptoms should be treated as soon as possible. If it is not, the infection can spread to other areas of your mouth. The most severe cases are treated in a hospital and may require intravenous antibiotics and surgery.

If you have symptoms of pericoronitis, make an appointment to see your dentist. If your wisdom teeth are coming in, visit your dentist at least twice a year for regular check-ups. During those visits, the dentist can check on the progress of your wisdom teeth.

Dr Sharon Robinson DDS has offices at the Dental Place Cosmetix Spa located at Shop #5, Winchester Business Centre, 15 Hope Road, Kingston 10. Dr Robinson is an adjunct lecturer at the University of Technology, Jamaica, School of Oral Health Sciences. She may be contacted at 630-4710. Like their Facebook page, Dental Place Cosmetix Spa, for an opportunity to take advantage of weekly specials.