Pericoronitis: Symptoms, Causes, and Treatment of Wisdom Tooth Infection
Pericoronitis is the infection and inflammation of the gum tissue surrounding a partially erupted tooth, most commonly a wisdom tooth.
It usually affects the lower third molars and occurs when bacteria and food debris become trapped under the gum flap covering the tooth.
Although mild cases may improve temporarily, untreated pericoronitis can become extremely painful and sometimes lead to serious infections.
This article explains what pericoronitis is, why it happens, symptoms to watch for, and how it is treated.
What Is Pericoronitis?
Pericoronitis is the inflammation of the soft tissue around a partially erupted tooth.
The term comes from:
- “Peri” = around
- “Corona” = crown of the tooth
It most often occurs when a wisdom tooth only partially breaks through the gums, leaving a flap of tissue where bacteria accumulate.
Why Does Pericoronitis Usually Affect Wisdom Teeth?
Wisdom teeth are the teeth most likely to erupt incompletely.
This happens because:
- There is not enough space in the jaw
- The tooth erupts at an angle
- Part of the tooth remains trapped under the gum
This creates an ideal environment for:
- Bacteria
- Food particles
- Plaque buildup
The area becomes difficult to clean properly, increasing infection risk.
What Causes Pericoronitis?
The main cause is bacterial accumulation around a partially erupted tooth.
Common contributing factors include:
- Poor oral hygiene: Food and bacteria become trapped under the gum flap.
- Impacted wisdom teeth: Teeth that cannot erupt normally increase irritation and infection risk.
- Trauma from opposing teeth: Upper teeth may bite down on swollen gum tissue.
- Stress or weakened immunity: Can worsen inflammation and infection.
- Previous episodes of inflammation: Recurrent irritation makes future infections more likely.
Symptoms of Pericoronitis
Symptoms can range from mild irritation to severe infection.
Common symptoms:
- Pain around a wisdom tooth
- Swollen gums
- Redness and inflammation
- Bad taste or bad breath
- Difficulty chewing
More severe symptoms:
- Difficulty opening the mouth (trismus)
- Swollen lymph nodes
- Facial swelling
- Fever
- Pus discharge
Symptoms often worsen over several days.
What Does Pericoronitis Feel Like?
Patients often describe:
- Throbbing pain behind the molars
- Pain when swallowing or chewing
- Gum tenderness
- Pressure in the jaw
In severe cases, pain can radiate to the ear, throat, or jaw.
Acute vs Chronic Pericoronitis
🔸 Acute pericoronitis
- Sudden and painful
- Significant swelling and infection
- May require urgent treatment
🔸 Chronic pericoronitis
- Mild but recurrent symptoms
- Intermittent discomfort or bad taste
- Often returns repeatedly without definitive treatment
Is Pericoronitis Dangerous?
It can become serious if untreated.
Potential complications include:
- Spread of infection to deeper tissues
- Facial cellulitis
- Abscess formation
- Difficulty swallowing or breathing (rare but serious)
Severe infections require immediate dental or medical care.
How Is Pericoronitis Diagnosed?
Diagnosis involves:
- Clinical examination of the wisdom tooth area
- Evaluation of swelling and gum flap
- X-rays to assess tooth position and impaction
- Assessment of infection severity
Dentists determine whether the tooth can erupt normally or requires removal.
How Is Pericoronitis Treated?
Treatment depends on severity and recurrence.
🔹 Cleaning and Irrigation
Dentists clean the area to remove:
- Food debris
- Plaque
- Bacteria
This often provides immediate relief in mild cases.
🔹 Pain and Inflammation Control
May include:
- Anti-inflammatory medications
- Warm saltwater rinses
- Improved oral hygiene
🔹 Antibiotics
Used when infection spreads or symptoms are severe.
Common indications:
- Fever
- Facial swelling
- Pus discharge
- Difficulty swallowing
Antibiotics alone are not a permanent solution if the tooth remains problematic.
🔹 Operculectomy
Removal of the gum flap covering the tooth. This may reduce trapping of bacteria, but recurrence is still possible.
🔹 Wisdom Tooth Extraction
The most definitive treatment in recurrent or severe cases.
Extraction is often recommended when:
- The tooth is impacted
- There is insufficient space
- Recurrent infections occur
Can Pericoronitis Go Away on Its Own?
Mild cases may temporarily improve, but recurrence is common if the underlying issue remains.
Without treatment:
- Infection may return repeatedly
- Symptoms can worsen over time
How Long Does Pericoronitis Last?
- Mild cases: a few days with treatment
- Moderate cases: 1–2 weeks
- Severe infections: longer if complications occur
Healing depends on whether the wisdom tooth is ultimately treated.
How to Prevent Pericoronitis
🔹 Maintain good oral hygiene: Carefully clean around erupting wisdom teeth.
🔹 Use antibacterial rinses if recommended: Helps reduce bacterial accumulation.
🔹 Monitor wisdom teeth early: Regular dental evaluations identify problems before infection develops.
🔹 Consider early extraction when indicated: Preventive removal may reduce future complications.
When Should You See a Dentist?
You should seek evaluation if you have:
- Pain behind the molars
- Swollen gum around a wisdom tooth
- Difficulty opening your mouth
- Fever or facial swelling
- Bad taste or pus discharge
Prompt treatment prevents progression.
Conclusion
Pericoronitis is a common infection affecting the gum tissue around partially erupted wisdom teeth.
It develops when bacteria and debris accumulate under the gum flap surrounding the tooth.
While mild cases may improve temporarily, recurrent or severe pericoronitis often requires definitive treatment, including wisdom tooth extraction.
Early dental evaluation is essential to prevent it from turning into a severe oral disease and relieve pain effectively.
FAQ About Pericoronitis
Is pericoronitis a wisdom tooth infection?
Yes. It usually occurs around partially erupted wisdom teeth.
Can antibiotics cure pericoronitis?
They help control infection, but the underlying tooth problem may remain.
Does pericoronitis always require extraction?
No, but recurrent cases often do.
Is pericoronitis painful?
Yes. It can become extremely painful if inflammation worsens.
Can pericoronitis spread?
Yes. Untreated infections can spread into surrounding tissues.
References
Kwon G, Serra M. Pericoronitis. [Updated 2022 Nov 21]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK576411/
Hupp, J. R., Ellis, E., & Tucker, M. R. (2018). Contemporary oral and maxillofacial surgery (7th ed.). Elsevier.
Kay L. Investigations into the nature of pericoronitis—II. British Journal of Oral Surgery, 4, 52-78