Pericoronitis

Written by Alyson Powell Key
Medically Reviewed by Robert Brennan, DDS on February 06, 2025
5 min read

Pericoronitis is an inflammation or swelling of your gum tissue. More common in your lower teeth, it usually happens around your wisdom teeth — the third and final set of molars that most people get in their late teens or early 20s.

Pericoronitis vs. gingivitis

Gingivitis is a milder type of gum disease that can leave your gums around the base of your teeth (gingiva) red, swollen, and bleeding. If you don't treat gingivitis, it can cause tooth loss and a serious gum disease called periodontitis. Poor dental habits, such as not brushing and flossing enough or skipping dentist visits, cause gingivitis.

Pericoronitis can develop when wisdom teeth only partially erupt (break through the gum). "A lot of times, wisdom teeth will come out in a slanted position, and that will cause pericoronitis where the tissue is swollen over the area," explained Irina Kessler, MD, who is a cosmetic dentist at New York Family Dental Arts. "The tooth underneath needs to be extracted because it's not coming up in the right position and there isn't room in the jaw for it."

When a wisdom tooth erupts only partially, a flap of gum tissue called an operculum can form over it. Bacteria can get trapped under this flap. That allows an opening for bacteria to enter around the tooth and cause infection and swelling. Food debris, bacteria, or plaque (a bacterial film that remains on teeth after eating) may also get caught underneath the gingiva, a flap of gum around a tooth. If it stays there, it can irritate the gum and lead to pericoronitis. In serious cases, the swelling and infection may extend beyond the jaw to the cheeks and neck.

Factors that may raise your chance of pericoronitis include:

  • Being in your 20s
  • An upper respiratory tract infections
  • Emotional stress
  • Poor oral hygiene

Symptoms of pericoronitis can be either acute (short-term) or chronic (ongoing).

Acute symptoms include:

  • Pain
  • Swelling in the gum tissue (caused by an accumulation of fluid)
  • Pus discharge
  • Trismus, or difficulty opening your mouth and jaw, also called lockjaw
  • Pain with swallowing
  • Fever
  • Loss of appetite
  • Infection
  • Swollen submandibular lymph nodes in the neck

Chronic symptoms include:

  • Occasional dull pain or mild discomfort
  • A bad taste in the mouth

See your dentist promptly if you notice signs of pericoronitis, including pain, fever, or gum bleeding. Symptoms of a possible life-threatening infection include face swelling, swollen lymph nodes, and jaw spasms, which also call for a visit to the dentist.

 

Your dentist will examine your wisdom teeth to see how they are coming in and if they are partially erupted. They may take an X-ray periodically to look at the alignment of the wisdom teeth. Your dentist will also take note of any symptoms such as swelling or infection, and will check for the presence of a gum flap around the wisdom tooth.

Pericoronitis is treated by your general dentist or one of these specialists:

  • Pedodontist or pediatric dentist
  • Endodontist
  • Periodontist
  • Prosthodontist
  • Oral surgeon

Treatments for pericoronitis include:

Oral hygiene/oral irrigators and rinses. If pericoronitis is in a small area and hasn't spread, treatment may be rinsing your mouth with warm salt water. Your dentist can flush out food debris or bacteria, or give you an oral rinse. You'll need to make sure to keep the gum flap free of any trapped food.

Pain medicine. You can take pain relievers such as aspirin, acetaminophen, or ibuprofen. Your dentist may also prescribe you a pain medication.

Antibiotics. If your tooth, jaw, and cheek are swollen and painful, see your dentist right away. They can treat the infection with antibiotics (usually penicillin, unless you are allergic).

Minor surgery to remove the operculum. If the pain and inflammation are severe or if pericoronitis recurs, oral surgery may be necessary to remove the gum flap or wisdom tooth. Your dentist can make the appropriate referral to the oral and maxillofacial surgeon. A low-level laser can be used to reduce pain and inflammation linked to pericoronitis.

Extraction. If a wisdom tooth still can't come in normally, surgery may be needed to take it out. Your dentist may recommend you extract both your upper and lower wisdom teeth to prevent your upper tooth from biting your gum and causing another infection.

Here are a few home remedies to soothe your pericoronitis symptoms:

  • A saltwater rinse three to four times daily
  • An alcohol-free mouthwash twice daily to help prevent bacteria
  • Acetaminophen or ibuprofen to ease pain
  • Regular brushing and flossing

It's possible to get pericoronitis even when you take good care of your teeth and gums, but there are ways to lower your chances:

  • Brush and floss regularly.
  • Use a mouthwash that helps prevent bacteria.
  • See your dentist for regular cleanings and checkups.
  • Follow other suggestions from your dentist.

"If you routinely go for your cleaning visits, sometimes pericoronitis can be avoided by having a consultation regarding your wisdom teeth before they get infected," Kessler says.

With mild symptoms of pericoronitis, your dentist may monitor your condition for any changes. But if you have a serious case, you'll probably need surgery or removal of your wisdom teeth. Untreated pericoronitis can cause other health problems, including life-threatening infections.

  • Pericoronitis is the swelling and inflammation of your gum tissue.
  • It's most common around partially erupted wisdom teeth in young adults.
  • Pericoronitis happens when bacteria, food particles, or plaque get trapped under your gum flap, leading to infection and discomfort.
  • Symptoms range from mild pain and a bad taste in your mouth to severe swelling, fever, and trouble opening your jaw.
  • Treatment for pericoronitis includes rinsing the affected area with salt water, taking pain relievers or antibiotics, or, in severe cases, having surgery to remove the gum flap or your wisdom tooth.
  • Good oral hygiene, regular dental visits, and early treatment can help avoid or manage pericoronitis.

Can pericoronitis heal on its own?

Yes, pericoronitis can get better without treatment. Your dentist may keep track of your condition to make sure your symptoms get better over time.

What are the stages of pericoronitis?

Pericoronitis usually starts with pain and swelling at the back of your mouth, often near a partially erupted wisdom tooth. The pain can spread to nearby areas. It may get worse when you chew or over time. If it gets worse, your symptoms may include a bad taste in your mouth, bad breath, pus, trouble opening your mouth, and trouble swallowing.