Pericoronitis around Wisdom Teeth

If the back of the lower jaw is not long enough for the third molar (wisdom tooth) to come through and clear the gum at the back of it, there may be some gum still hanging over the top of the tooth. Typically wisdom teeth will grow into the mouth from the age of 18 or older. Food and bacteria can go in under this flap of gum and cause an infection which over time can become acute with symptoms such as;

  • Swelling and redness of that flap of gum over the back of the wisdom tooth.
  • The swollen flap is painful to touch with your finger
  • Pain and throbbing which radiates along the jaw towards the ear, and generally that side of the face which may be strong enough to interfere with sleep
  • Sometimes painful to close together if the upper wisdom tooth is biting down on it
  • Trissmus- difficulty in opening the mouth fully due to muscle spasm.

In more advanced:

  • Swelling of the outside cheek towards the back of the jaw
  • A bad taste and breath from drainage of pus
  • Fever and an unwell feeling
  • Swelling into floor of mouth (Ludwig’s Angina), which if extreme can compromise the airway. This is rare and requires one to go straight to hospital.

If an acute advanced infection, one needs to take a course of antibiotics to settle it prior to planning either trimming the flap of soft tissue or extraction of the wisdom tooth at a later date. If you cannot find a dentist, a medical practitioner can give you antibiotics to start the process of getting it better. If no allergy to penicillian, Augmentin Duo for moderate and Augmentin  Duo Forte for a major infection is ideal.  Sometimes your practitioner will add Flagyll as well if the infection is extreme. If there is allergy to penicillin, Dalacin-C is a very good alternative. If your pericoronitis is mild with no restricted mouth opening, sometimes the wisdom tooth can be extracted on your first visit and the whole problem is sorted out immediately.

For wisdom tooth removal, please see Cosmetic, General and Surgical Services.

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