What Is Pericoronitis?
Pericoronitis is inflammation of the soft tissue surrounding a tooth that has only partially erupted through the gum. The condition most commonly affects wisdom teeth—the third molars that typically emerge between the ages of 17 and 25.
When a wisdom tooth doesn't fully emerge, a flap of gum tissue often remains over part of the tooth's surface. This flap, called an operculum, creates a pocket where food particles and bacteria can become trapped. Because this area is difficult to clean, bacteria can multiply and cause inflammation or infection.
Wisdom teeth are particularly prone to pericoronitis because they are the last teeth to emerge and often lack sufficient space in the jaw to come through completely. The resulting partial eruption creates ideal conditions for this type of inflammation to develop.
Common Causes of Wisdom Tooth Pain
Wisdom tooth pain can arise from several causes. Only a dental professional can confirm the specific reason for your discomfort following examination.
Partially Erupted Wisdom Teeth
When a wisdom tooth only partially breaks through the gum, a flap of tissue can cover part of the tooth, creating a space where bacteria and food can accumulate.
Gum Infection Around the Tooth
Bacteria trapped beneath the gum flap can multiply, causing infection and inflammation in the surrounding tissue.
Tooth Decay Affecting Wisdom Teeth
Wisdom teeth at the back of the mouth can be difficult to clean, making them more susceptible to decay, which can cause pain.
Impacted Wisdom Teeth
When a wisdom tooth is blocked from erupting properly—often by the adjacent tooth or bone—pressure can build, causing discomfort.
Difficulty Cleaning the Area
The position of wisdom teeth at the very back of the mouth makes effective brushing and flossing challenging, increasing the risk of problems.
Symptoms of Pericoronitis and Wisdom Tooth Pain
The symptoms of pericoronitis and wisdom tooth problems can vary from mild discomfort to more significant pain and swelling. Common symptoms include:
Pain at the Back of the Mouth
Aching, throbbing, or sharp pain in the area where wisdom teeth are located.
Swollen, Red, or Bleeding Gums
Inflammation of the gum tissue around the wisdom tooth, which may bleed when touched.
Bad Taste or Unpleasant Breath
An unpleasant taste or persistent bad breath caused by bacteria and infection.
Difficulty Opening the Mouth
Reduced jaw movement or pain when trying to open the mouth fully (trismus).
Pain When Chewing
Discomfort or sharp pain when biting down, particularly on the affected side.
Jaw Stiffness or Swelling
Stiffness in the jaw or visible swelling in the cheek or jaw area.
Symptoms can range from mild to severe and may develop gradually or appear quite suddenly.
When Wisdom Tooth Pain Needs Urgent Dental Assessment
While mild wisdom tooth discomfort may settle on its own, certain symptoms suggest that professional assessment should not be delayed. Consider seeking dental care if you experience:
- Pain that is worsening or not improving with time
- Swelling developing in the jaw, cheek, or face
- Difficulty opening the mouth fully or swallowing
- Fever or feeling generally unwell
- Pain spreading to the ear, throat, or other areas of the jaw
These symptoms may indicate that infection is more significant and would benefit from professional assessment and management.
How Dentists Assess Wisdom Tooth Pain
When you visit a dentist with wisdom tooth pain, they will conduct a thorough assessment to understand the cause and determine the most appropriate approach:
- Clinical examination: The dentist will examine the wisdom tooth area, assessing the position of the tooth, the condition of the surrounding gum, and any signs of infection or inflammation.
- Dental X-rays: Radiographs help visualise the position of the wisdom tooth, whether it is impacted, its relationship to adjacent teeth and nerves, and any associated pathology.
- Assessment of surrounding tissues: The dentist will evaluate whether infection has spread beyond the immediate area and check for any impact on jaw movement or swallowing.
This comprehensive assessment informs decisions about whether the tooth can be managed conservatively or whether removal may be advisable.
Treatment Options for Painful Wisdom Teeth
Treatment for wisdom tooth pain depends on the cause, severity, and likelihood of recurrence. Options may include:
Cleaning and Managing Infection
The dentist may clean the area around the wisdom tooth, flushing out debris and bacteria from beneath the gum flap to help resolve inflammation.
Short-term Measures
Warm salt water rinses and maintaining good oral hygiene can help manage symptoms while the area heals. In some cases, the dentist may prescribe antibiotics if infection is spreading.
Monitoring Recurrent Episodes
If pericoronitis occurs once and resolves well, the dentist may recommend monitoring the tooth rather than immediate removal, particularly if the tooth may still fully erupt.
Wisdom Tooth Removal
If pain or infection recurs, or if the tooth is impacted and unlikely to erupt properly, extraction may be recommended to prevent ongoing problems.
Your dentist will discuss the options with you and recommend an approach based on your specific situation. The decision to remove a wisdom tooth is made individually, weighing the benefits against any risks.
Professional Care for Wisdom Tooth Pain
If you are experiencing ongoing or significant wisdom tooth pain, professional dental assessment can help identify the cause and determine the most appropriate management approach. Early evaluation can help prevent complications and provide relief from discomfort.
Depending on your symptoms, you may benefit from urgent dental assessment if pain is severe or worsening. If recurring problems occur, wisdom tooth removal may be recommended to prevent further episodes. Our general dental care options include assessment and management of wisdom tooth problems.
Wisdom tooth assessment is available at both our Central London locations: our South Kensington dental clinic and our City of London clinic near St Paul's.
Can Wisdom Tooth Pain Go Away on Its Own?
Mild symptoms of pericoronitis may settle temporarily, particularly with good oral hygiene and gentle cleaning of the affected area. Some people experience a single episode that resolves and doesn't return.
However, if the underlying cause remains—such as a partially erupted tooth with a gum flap—symptoms often recur. Each episode of infection can potentially become more severe than the last. Additionally, if a wisdom tooth is impacted or decayed, these issues will not resolve without professional treatment.
Even if symptoms appear to improve, having the area assessed by a dentist is advisable. They can evaluate whether the tooth is likely to fully erupt, whether ongoing problems are expected, and whether preventive measures or treatment would be beneficial.
Reducing the Risk of Wisdom Tooth Problems
While wisdom tooth problems cannot always be prevented, these measures can help reduce your risk:
- Attend regular dental check-ups so emerging wisdom teeth can be monitored
- Have wisdom teeth assessed early if you notice them starting to come through
- Take extra care to clean thoroughly at the back of the mouth
- Seek dental advice if you experience recurring discomfort around wisdom teeth
- Consider assessment if wisdom teeth are partially erupted and difficult to keep clean
