Pericoronitis: Difference between revisions
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*ED debridement of the operculum or debris is usually not indicated | *ED debridement of the operculum or debris is usually not indicated | ||
*Refer to dentist for surgical excision of the operculum and/or removal of the offending tooth | *Refer to dentist for surgical excision of the operculum and/or removal of the offending tooth | ||
* | *Mild to moderate pericoronitis can be treated with oral antibiotics, severe infections require intravenous antibiotics and admission. | ||
*Complications: Deep soft tissue infection | |||
*[[Penicillin VK]] 500mg PO QID '''OR''' [[clindamycin]] 300mg PO QID | *[[Penicillin VK]] 500mg PO QID '''OR''' [[clindamycin]] 300mg PO QID | ||
Revision as of 18:35, 26 November 2017
Background
- Occurs during tooth eruption through the gingiva
- Food and bacteria can accumulate between the erupting tooth and operculum (flap of gingiva) leading to infection and pain
- The wisdom tooth (3rd molar) is the most common site of pericoronitis
Clinical Features
- Pain at site of recent tooth eruption with operculum
Differential Diagnosis
Dentoalveolar Injuries
Odontogenic Infections
- Acute alveolar osteitis (dry socket)
- Acute necrotizing ulcerative gingivitis (trench mouth)
- Dental abscess
- Periapical abscess
- Periodontal abscess
- Ludwig's angina
- Pulpitis (dental caries)
- Pericoronitis
- Peritonsillar abscess (PTA)
- Retropharyngeal abscess
- Vincent's angina - tonsillitis and pharyngitis
Other
Evaluation
- Clinical diagnosis
Management
- Analgesia (often requires dental block)
- Treat with chlorhexidine rinses, a randomized trial showed green tea was equally effective [1]
- ED debridement of the operculum or debris is usually not indicated
- Refer to dentist for surgical excision of the operculum and/or removal of the offending tooth
- Mild to moderate pericoronitis can be treated with oral antibiotics, severe infections require intravenous antibiotics and admission.
- Complications: Deep soft tissue infection
- Penicillin VK 500mg PO QID OR clindamycin 300mg PO QID
Disposition
- Discharge with dental follow-up
See Also
References
- ↑ Shahakbari R, Eshghpour M, Rajaei A, et al. Effectiveness of green tea mouthwash in comparison to chlorhexidine mouthwash in patients with acute pericoronitis: a randomized clinical trial. Int J Oral Maxillofac Surg. 2014;43(11):1394- 1398