Pericoronitis

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Pericoronitis is an inflammation of the soft tissue surrounding the crown of a partially erupted or impacted tooth.

Causes

  • Accumulation of bacteria and food debris beneath the gum.
  • Trauma to the gum flap from opposing tooth 

Types

Acute and Chronic

Signs and symptoms

  • Tenderness around impacted tooth
  • Facial swellings
  • Dysphagia
  • Enlargement of regional lymph nodes
  • Pain
  • Difficulty in opening the mouth
  • Fever

Investigations

  • Physical examination
  • X ray to determine the alignment of the affected tooth.

Treatment objectives

  • Manage or alleviate the pain near the affected tooth
  • Reduce inflammation

Non-pharmacological treatment

  • Rinse mouth with warm saline mouth wash
  • Removal of the gum flap (Operculectomy)
  • Disimpaction of the third molar by surgical extraction
  • Occlusal reduction of opposing tooth

Pharmacological treatment

Paracetamol oral

Adult:

500mg-1g every 6-8 hours

Child:

6-12 years: 250-500mg every 6-8 hours

1-5 years: 120-250mg every 6-8 hours,

3 months-1 year: 60-120mg every 6-8 hours when required

 

OR

Ibuprofen oral

Adult:

200-400mg every 8 hours 

Child:

100-200mg every 8 hours

 

AND

Amoxicillin oral:

Adult:

500mg every 8 hours for 7days

Child:

6-12 years:  250mg every 8 hours for 7 days

1-5 years 125mg every 8 hours for 7 days,

<1 year:   62.5mg every 8 hours for 7days

 

OR

Metronidazole oral

Adult:

400mg every 8 hours for 7 days

Child:

100-200mg every 8 hours for 7days

Referral

Dentist for definitive treatment 

PreventionPractice good oral hygiene