Pericoronitis: Difference between revisions
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*Food and bacteria can accumulate between the erupting tooth and operculum (flap of gingiva) leading to infection and pain | *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 | *The wisdom tooth (3rd molar) is the most common site of pericoronitis | ||
==Clinical Features== | |||
[[File:Pericoronitis.jpg|thumb|Pericoronitis]] | [[File:Pericoronitis.jpg|thumb|Pericoronitis]] | ||
*[[dental pain|Pain]] at site of recent tooth eruption with operculum | |||
*Pain at site of recent tooth eruption with operculum | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
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==Management== | ==Management== | ||
*Analgesia (often requires dental block) | ===Mild to Moderate=== | ||
* | *[[Analgesia]] (often requires dental block) | ||
*Chlorhexidine rinses (a randomized trial showed green tea was equally effective)<ref>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</ref> | |||
*[[Penicillin VK]] 500mg PO QID '''OR''' [[clindamycin]] 300mg PO QID | |||
*ED debridement of the operculum or debris is usually not indicated | *ED debridement of the operculum or debris is usually not indicated | ||
===Severe=== | |||
*[[ | *Severe infections require intravenous [[antibiotics]] and admission | ||
*Complications: Deep soft tissue infection | |||
==Disposition== | ==Disposition== | ||
*Discharge with dental follow-up | ===Mild to Moderate=== | ||
*Discharge with dental follow-up | |||
**Refer to dentist for surgical excision of the operculum and/or removal of the offending tooth | |||
===Severe=== | |||
*Admit | |||
==See Also== | ==See Also== | ||
Revision as of 22:26, 30 September 2019
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
Mild to Moderate
- Analgesia (often requires dental block)
- Chlorhexidine rinses (a randomized trial showed green tea was equally effective)[1]
- Penicillin VK 500mg PO QID OR clindamycin 300mg PO QID
- ED debridement of the operculum or debris is usually not indicated
Severe
- Severe infections require intravenous antibiotics and admission
- Complications: Deep soft tissue infection
Disposition
Mild to Moderate
- Discharge with dental follow-up
- Refer to dentist for surgical excision of the operculum and/or removal of the offending tooth
Severe
- Admit
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