Pericoronitis: Causes, Symptoms & Treatment Guide

Pericoronitis is a painful and potentially serious dental condition that affects the gum tissue surrounding a partially erupted tooth — most commonly the third molars, also known as wisdom teeth. This condition arises when the gum flap (operculum) covering a developing molar traps bacteria, food particles, and plaque, creating an ideal environment for infection.

At Brighton Implant Clinic, we frequently treat pericoronitis in individuals aged late teens to early 20s, a period when wisdom teeth typically erupt.

Left untreated, this condition can escalate into a spreading infection, posing systemic risks to a patient’s health and quality of life.

Wisdom Teeth and the Operculum: How Anatomy Plays a Role

Wisdom teeth are the last molars to emerge in the oral cavity, often erupting when there’s insufficient space in the jaw. As a result, they may become impacted or only partially erupt through the gums. When this happens, a small flap of gum tissue forms over the tooth — called an operculum.

This flap of gum tissue can act like a trap, catching food particles, plaque, and bacteria. Inadequate cleaning due to limited access around the partially erupted tooth can lead to localised inflammation, and in more severe cases, an abscess or pus formation.

If upper and lower wisdom teeth clash during biting, they may aggravate the inflamed gum tissue and increase the risk of acute pericoronitis.

What Causes Pericoronitis?

Pericoronitis typically occurs when a wisdom tooth only partially erupts through the gum tissue, creating a small pocket or flap of gum (called an operculum) that easily traps food, plaque, and bacteria. These trapped particles foster an environment where harmful microorganisms can thrive, leading to localised infection and inflammation.

Several interrelated factors contribute to the development and persistence of pericoronitis:

• Partial Eruption or Impaction: When a third molar fails to fully break through the gum line, it leaves the area exposed and difficult to clean. This is especially common in lower wisdom teeth, which often have limited space to erupt.
• Accumulation of Food Debris and Plaque: The flap of gum tissue around your wisdom teeth is prone to collecting particles from meals. Without proper cleaning, this debris becomes a breeding ground for bacteria, which can lead to pus formation, foul odour, and even bad breath.
• Poor Oral Hygiene: The back of the mouth can be challenging to clean effectively. Missed brushing or flossing around the partially erupted tooth allows bacteria to build up and cause pericoronitis.
• Trauma from the Opposing Tooth: In many cases, the upper molar may bite down on the gum flap of the lower, partially erupted molar. This trauma aggravates the tissue, increasing the risk of infection and making it harder for the gum to heal.
• Compromised Immunity or Stress: Factors like stress, hormonal changes, illness, or weakened immune response can lower your body’s ability to fight off the infection, accelerating the progression of pericoronitis.

It's also worth noting that teens and individuals in their early twenties are particularly susceptible because this is the period when wisdom teeth usually erupt. If left untreated, acute pericoronitis can quickly worsen, causing a spreading infection that may affect the jaw, throat, or neck.

Understanding these causes is crucial in preventing recurrence and choosing the right treatment option - whether through enhanced oral hygiene, removal of the gum flap, or wisdom teeth removal entirely.

Types of Pericoronitis: Acute vs. Chronic

Pericoronitis can present in different ways. Dentists classify it as either acute or chronic, depending on the duration and intensity of the symptoms.

Acute Pericoronitis

This form is sudden and painful, often accompanied by:

• Severe swelling
• Red, inflamed gum tissue
• Pain when chewing or opening the mouth
• Pus or discharge
• Swollen lymph nodes
• Fever and malaise

Chronic Pericoronitis

In chronic cases, symptoms come and go, often linked to poor cleaning habits or recurrent food entrapment. Although less intense, chronic pericoronitis can quickly escalate if left untreated.

Common Symptoms of Pericoronitis

The symptoms of pericoronitis can range from mild discomfort to severe pain and swelling, depending on how advanced the infection is. For many patients, the first sign of trouble is a persistent soreness or tenderness near the back of the mouth, typically where a wisdom tooth is partially erupting.

Here are the most frequently reported symptoms — each of which may appear alone or in combination:

• Pain and Swelling: One of the hallmark signs is painful, swollen gum tissue around the partially erupted wisdom tooth. This discomfort may worsen when chewing or brushing, especially if the flap of gum tissue has become inflamed or irritated.
• Trismus (Difficulty Opening the Mouth): In moderate to severe cases, inflammation can spread to the muscles involved in jaw movement, causing a condition known as trismus. Patients often describe feeling “locked” or unable to open their mouth fully, which complicates eating and speaking.
• Unpleasant Taste or Bad Breath: The buildup of pus, bacteria, and decaying food debris under the gum flap can produce a foul taste or persistent bad breath (halitosis). This is often one of the first signs noticed by patients or those around them.
• Pus Discharge: If the infection progresses, the body may attempt to drain it by forming an abscess. You might see or taste pus leaking from the site, indicating an active and spreading infection that requires immediate dental attention.
• Swollen Lymph Nodes and Fever: As the body mounts an immune response, nearby lymph nodes in the neck and jaw may become swollen and tender. Fever and general fatigue may also develop, especially in cases of acute pericoronitis.
• Redness and Bleeding: The gum tissue around your wisdom teeth can appear red, inflamed, and may bleed easily when brushing or flossing, further complicating oral hygiene efforts.
  
  

Below is a more detailed comparison of early vs. advanced symptoms of pericoronitis:

If you experience multiple symptoms simultaneously, particularly those associated with swelling, limited mouth movement, or pus, it’s essential to seek urgent care. Pericoronitis can quickly escalate into a more serious oral or systemic infection if left untreated.

At Brighton Implant Clinic, we encourage early intervention - even if symptoms seem minor - to prevent more invasive treatments later and preserve your long-term oral health.

How Is Pericoronitis Diagnosed?

A clinical dental examination is the first step in diagnosing pericoronitis. At Brighton Implant Clinic, we follow a structured approach:

• Visually assess gum tissue around the erupting tooth
• Check for pain, swelling, or discharge
• Evaluate the extent of eruption and space in the jaw
• Take digital X-rays to examine root positioning, tooth impaction, and rule out other causes like tooth decay or periodontal disease

A timely pericoronitis diagnosis helps prevent complications such as spreading infection or damage to adjacent teeth.

Pericoronitis Treatment Options

Treating pericoronitis effectively depends on several key factors: the severity of the infection, the frequency of flare-ups, and the position of the affected wisdom tooth. At Brighton Implant Clinic, we tailor each treatment plan to the unique needs of the patient, ensuring a balance between immediate symptom relief and long-term prevention.

Mild or first-time cases may only require conservative management, including professional cleaning, medication, and home care. However, for more persistent or severe cases, surgical intervention is often necessary to eliminate the root cause and prevent recurrence. Below, we break down both types of treatment paths.

Non-Surgical Treatment for Pericoronitis

For many patients experiencing pericoronitis for the first time, especially when symptoms are still mild or moderate, non-surgical treatment is often effective. These approaches aim to control infection, alleviate pain, and promote healing without the need for invasive procedures.

Common non-surgical interventions:

• Professional Cleaning: Dentists will gently clean the area under and around the flap of gum tissue (operculum) to remove trapped food particles, plaque, and pus, reducing bacterial load and inflammation.
• Oral Antibiotics: Infections that show signs of spreading or pus formation are typically treated with a short course of antibiotics such as amoxicillin, metronidazole, or a combination, depending on the severity and the patient’s health profile.
• Antiseptic Mouth Rinses: Solutions like chlorhexidine help reduce bacterial buildup and aid in the healing of gum tissues. These are typically prescribed for daily use over a limited period.
• Pain Relievers: Over-the-counter or prescription-strength anti-inflammatory medications, such as ibuprofen, are recommended to reduce pain and swelling associated with pericoronitis.
• Irrigation of the Infected Site: Flushing the area with sterile saline or antiseptic solutions may be done in-clinic or recommended as part of home care to prevent reinfection.
  
  

These treatments are most effective for short-term management, especially in patients with adequate space for the wisdom tooth to erupt and no previous history of recurrence.

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Surgical Treatment for Pericoronitis

When non-surgical methods fail, or if the condition returns frequently, surgical options are explored. These are designed to permanently resolve the anatomical issue contributing to the infection - most often the presence of a gum flap or an impacted wisdom tooth.

Surgical interventions may include:

• Operculectomy: This minor surgical procedure involves the removal of the operculum, the flap of gum tissue that traps debris. It’s usually performed under local anaesthesia and can dramatically reduce the recurrence of pericoronitis if the wisdom tooth is expected to fully erupt.
• Wisdom Teeth Removal (Tooth Extraction): When the third molar is severely impacted, misaligned, or causing repeated infections, removal becomes the most effective long-term solution. This procedure is performed by either a general dentist or an oral and maxillofacial surgeon, depending on complexity.
• Referral for Complex Cases: If the infection has spread to nearby tissues or if the tooth’s roots are located close to nerves or sinus cavities, referral to an oral and maxillofacial specialist ensures safe, expert care.

Surgical treatment is especially important when pericoronitis leads to abscess formation, spreading infection, or persistent inflammation that affects a patient’s ability to eat, speak, or open their mouth normally.

Home Remedies and Self-Care Tips

While professional treatment is crucial, certain at-home practices can help reduce discomfort and promote healing during a mild episode — or while awaiting a dental appointment. 

These remedies are safe and effective when used in conjunction with professional advice, not as a replacement.

• Warm Saltwater Rinses: Rinsing the mouth 3–4 times daily with a saltwater solution (½ teaspoon of salt in a glass of warm water) helps reduce inflammation and draws out trapped pus or debris.
• Cold Compresses: Applying a cold pack to the jawline for 15 minutes at a time can relieve pain and minimise swelling.
• Over-the-Counter Painkillers: Medications like paracetamol or ibuprofen are useful for managing pain and reducing gum inflammation between dental visits.
• Good Oral Hygiene Practices: Carefully brushing and flossing around the back molars, including the affected area, can help control bacteria. Use a soft-bristled toothbrush to avoid irritating inflamed gums.
• Avoid Irritating Foods: Stay away from hard, crunchy, or sticky foods during flare-ups, as they can get lodged under the gum flap and worsen the condition.
  
  

It’s important to note that home remedies alone cannot resolve underlying anatomical issues, such as an impacted or malpositioned tooth. If you experience persistent pain, swelling, or any signs of a spreading infection (fever, swollen neck, pus), seek immediate dental care.

What Happens If Pericoronitis Is Left Untreated?

If pericoronitis is left untreated, it can cause serious complications including:

• Abscesses around the tooth
• Spread of infection to neck, throat, or cheeks
• Systemic infections like Ludwig’s angina (a rare but serious condition)
• Tooth decay or loss of adjacent teeth
• Chronic pain and inflammation that affects eating and speaking
  
  

Early intervention helps avoid the need for emergency oral surgery or prolonged antibiotic use.

Why Choose Brighton Implant Clinic for Pericoronitis Treatment?

At Brighton Implant Clinic, we provide comprehensive care for pericoronitis and wisdom teeth-related conditions:

• Expert diagnostics and digital imaging
• Surgical and non-surgical options
• Minimally invasive techniques
• Clinics across Brighton, Hove, Hailsham, and Worthing
• Access to oral and maxillofacial professionals
• Emphasis on preventive care and education
  
  

Our priority is to offer patient-centered solutions tailored to your unique oral health needs.

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Frequently Asked Questions (FAQs)

Can pericoronitis go away on its own?

In mild cases, symptoms may subside temporarily. However, without professional cleaning or treatment, the condition often returns or worsens.

Will I always need to have my wisdom tooth removed?

Not necessarily. If the tooth is expected to fully erupt, your dentist may opt to monitor it. However, if it remains impacted or causes recurrent infections, tooth extraction is the preferred long-term solution.

How long does pericoronitis last?

With prompt treatment, symptoms usually improve in 3–7 days. For surgical procedures like extraction or operculectomy, recovery may take up to two weeks.

Is pericoronitis contagious?

No, pericoronitis is not contagious. It results from local factors such as trapped debris and bacterial overgrowth in the mouth.

Can poor oral hygiene cause pericoronitis?

Yes. Inadequate cleaning around erupting wisdom teeth is a common trigger, especially when food particles and plaque accumulate beneath the gum flap.

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Conclusion: Don't Ignore the Signs

Pericoronitis is a common dental condition that can escalate quickly if not addressed. Whether you're experiencing early signs like mild swelling or severe symptoms like pus discharge or difficulty opening your mouth, it’s essential to consult a qualified dental professional.

At Brighton Implant Clinic, we combine clinical expertise, modern imaging, and a patient-first approach to deliver optimal care — whether through conservative treatment or wisdom teeth removal.

📞 Call us today at 0800 111 6623 or
💬 Book an appointment online to have your wisdom teeth and gums assessed by our expert team.

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