The improper or prolonged eruption of wisdom teeth often leads to gum tissue trauma, resulting in an inflammatory condition known as pericoronitis. This issue arises when wisdom teeth face challenges during eruption, such as obstructions from bone, periosteum, or soft gum tissue. Over time, a gingival hood can form over the erupting tooth, trapping food particles and bacteria, which then trigger inflammation. Additional factors, like gingival hyperplasia, malocclusion, or an abnormal tooth shape, can exacerbate the condition, leading to serious complications.

Types of Pericoronitis
Pericoronitis is classified into two main forms based on symptoms and severity:

Acute Pericoronitis
This occurs in 60-70% of lower molar eruptions and is characterized by a sudden onset of symptoms, such as severe pain and gum discharge. With proper treatment, symptoms typically subside within 3-5 days. Acute pericoronitis can manifest in different forms:

Catarrhal (mild inflammation)
Ulcerative (formation of ulcers)
Purulent (presence of pus)
Chronic Pericoronitis
Chronic cases develop gradually and can persist for months or even years. Symptoms are less severe but recurrent, often leading to tooth decay, soft tissue inflammation, and systemic complications if untreated.

Early detection and treatment by a dental professional are crucial to prevent the progression of the disease.

Symptoms of Pericoronitis
Pericoronitis symptoms is most common during the eruption of third molars (wisdom teeth). The early stages involve the formation of a gum hood, followed by symptoms such as:

Redness and swelling of the gums
Severe pain, especially while chewing
Bad breath or a bitter/purulent taste
Tooth loosening
Pain radiating to the ear or temple
Difficulty swallowing
Enlarged lymph nodes
Fever
Restricted mouth opening due to swelling
Ignoring these symptoms can lead to chronic pericoronitis or severe complications like osteomyelitis, abscesses, cysts, or ulcerative stomatitis. Prompt dental intervention is essential.

Causes of Pericoronitis
The primary cause is the inability of the erupting tooth to break through the gum completely, leading to the formation of a gingival hood. This hood traps bacteria and food particles, which are challenging to clean thoroughly, causing inflammation. Other contributing factors include:

Chronic oral conditions (e.g., caries, periodontitis, stomatitis)
Poor oral hygiene
Anatomical gum or bone structure anomalies
Jaw injuries
Genetic predisposition
Weak immune system
Stress
Excessive brushing during this period can also injure sensitive gums, further aggravating the condition. Instead, gentle rinsing with antiseptic solutions is recommended.

Pericoronitis Treatments
Treatment options depend on the severity of the condition. Dentists typically recommend the following:

Medication Therapy
In early stages, patients can manage symptoms at home with proper oral hygiene. This includes using a soft toothbrush, rinsing with warm salted water or antiseptic solutions, and maintaining a clean oral environment. However, if symptoms worsen, professional care is necessary.

Gingival Hood Incision
For recurrent or severe cases, surgical intervention may be needed. This procedure involves excising the gum hood under local anesthesia, followed by antiseptic rinsing to clean the area thoroughly. Laser excision is a modern alternative that minimizes bleeding, reduces the risk of infection, and shortens recovery time.

Wisdom Tooth Removal
If the wisdom tooth is severely misaligned or damaged, extraction may be the best solution. The decision depends on the tooth's condition and the patient’s overall oral health. The dentist uses forceps or surgical tools to remove the tooth, ensuring minimal discomfort with anesthesia.

Postoperative Care: After surgery, patients are advised to rinse with antiseptic solutions, use painkillers if necessary, and avoid irritating foods (spicy, hot, or crunchy). Rest and limited physical activity are also recommended for a faster recovery.

Prevention and Final Thoughts
The eruption of wisdom teeth is often a challenging process that can lead to pericoronitis and other dental complications. To prevent these issues:

Maintain regular dental check-ups.
Address early signs of inflammation promptly.
Follow proper oral hygiene practices.
Timely intervention is the key to preserving oral health and avoiding long-term complications. If you suspect pericoronitis, consult your dentist for a comprehensive evaluation and effective treatment plan.