The pericoronitis is an inflammatory process: symptoms and treatment
In fact, pericoronitis is an inflammatory process of the gingival outgrowth, which is formed from top to penetrate the eighth tooth. Differently it is called a hood. Due to the effects of some factors, under it there is a favorable environment for bacteria. And in those places where they are always present inflammation. This process is called pericoronitis. Familiar with it most people who have eight to erupt at a later age. Usually it happens after twenty years. This problem with the formation and inflammation of the hood only occurs when eruption of lower third molars. So, we can say pericoronitis is an inflammation of hood the bottom of the eight.
Etiological factors contributing to the development of pericoronitis
Most often, this is due to the presence of bacterial flora. She, in turn, appears in the following situations:
- Unsatisfactory care of the oral cavity;
- The conditions for accumulation of plaque and food remnants in the space under the hood;
- The occurrence of carious process at the seventh tooth on the distal contact surface.
But there are other things that influence the development of inflammation of the gingival hood. In cases when the tooth cut through properly due to the lack of space in the tooth row or high density of the jaw bone, it stays half covered with a piece of gum. If the top has got the antagonist, it can injure the gums when biting.
Also the hood may become inflamed when brushing too hard toothbrush. Because of her injured mucosa and there is a wound, and it already develops inflammation.
The same applies to the reception of too coarse and solid food. In addition, the remains of used products can remain under the hood, creating the best environment for bacteria.
The clinical course of pericoronitis
The first step is to understand what forms is isolated. Like other dental diseases, there is observed acute, chronic and aggravated over. First and last can be catarrhal or purulent form. Depends on the severity of clinical manifestations. You should learn each form separately.
Let’s start with the sharp current of pericoronitis. Most of the patient concerned about pain in the region of the third molar. She can give in the nearby region. During the inspection revealed that the gum hanging over him inflamed, edematous and erythematous. These features are characteristic catarrhal flow. The General condition does not suffer. But the patient cannot eat properly due to pain.
With regard to the purulent pericoronitis, the symptoms get worse and are accompanied by purulent exudate from under the hood. Peripheral lymph nodes are enlarged and painful when groping. The patient may have a fever to 39 degrees. There is a weakness, maybe even dizziness or headache. The patient completely refuses to eat. Still it’s hard for him to open his mouth due to severe pain. It is possible only to a certain level.
If the patient for some reason are not able to go to the dentist at the time of occurrence of pericoronitis, the process proceeds to chronic. In this case, the symptoms are not as bright and some may remain. For example, concerned about the unpleasant and painful sensations from time to time during chewing, strong opening the mouth and swallowing. Swollen lymph nodes also remains. Unfortunately, the patient begins to think that it is in itself, not knowing that inflammation may go into the surrounding soft and hard tissues. Exacerbation of chronic pericoronitis is characterized by the same clinical picture as acute forms.
Differential diagnosis of inflammation of the gingival hood
This disease must be differentiated from acute diffuse pulpitis and aggravated chronic granulomatous or granulomatous periodontitis. In the first case, a similar profile of pain such as sharp, radiating to the temporal, auricular region. Difference are local signs — hyperemia and swelling of mucosa around a dental crown, the presence of purulent discharge, difficulty in opening the jaws.
In the second situation are similar what is the difference in earlier diagnosis. That is, the signs of inflammation around the tooth, discharge of pus, etc. Their distinctive feature is that perikoronit occurs when neprorezaemye fully tooth. If you still have doubts at the correct diagnosis, then you should make a x-ray picture, which in periodontitis, there will be changes, namely bone resorption in the apex of the tooth root.
How to treat perikoronit
A lot depends on how the tooth is cut and the clinical picture of pericoronitis. If the hood is not visible, in what position is the lower third molar, there should be an x-ray examination. If he’s in the right direction goes, it is possible to do without removing it. With the exception of those cases where, despite the fact that he’s standing right still may not erupt for a very long time and perikoronit periodically recurs. But again, is to look into clinical manifestations.
These include excision of the gingival hood or the removal of wisdom teeth. What surgery should be undertaken is determined by the physician after careful consideration of subjective and objective data. A lot of the important role played by the x-ray. If you decide to save the tooth, and then excised mucosa of the gums, which is hanging on eight. Thus, the cusps of the tooth crowns are wide open and disappear a place where they can accumulate germs. Actually, this is a very easy operation and does not require much time.
All done under local infiltration anesthesia. After the onset of the mucous membranes treated with antiseptics and put it excision. This is done with a scalpel or special surgical scissors. Then stop the bleeding and put a tampon, saturated with iodoform. On this day the patient is not recommended is rude and a hot meal. You can do the rinsing, but after a couple of hours. Preferably not even to rinse and hold in mouth and spit. If necessary, prescribe antibiotics.
The purpose of this practice is rare, because the patient can still tolerate the unpleasant sensation of pain and did not consider it necessary to go to the dentist. But if you still made the visit at this stage, then, is primarily prescribed rinse. This should be used antiseptic and anti-inflammatory drugs. You can use chlorhexidine, furacilin, efficient. They destroy the bacterial flora. Also use tincture on herbal camp — stomatofit, maraslavin, rotokan. They relieve inflammation. Usually in this situation, these procedures enough. Should I do the rinse at least five times a day. But if there remains a plaque, even after normal cleaning to be sure to go to the hygienist that cleaned professionally. Because, in such circumstances, from rinsing will be no good. Because of plaque and bacteria can thrive. This is the treatment for pericoronitis.
Tooth extraction when pericoronitis
Before proceeding, you must wait until it calms acute symptoms of inflammation. Because there is a risk of infection in the wound. Eight must be deleted if it is crooked, resting on the seventh, if perikoronit all the time and recurs when the tooth can not erupt because of lack of space or too dense plates of the jawbone. Sometimes the question arises about whether to keep or remove when not and will not antagonist. Because, in this case, the third molar has no function value.
Surgery starts with a local anesthesia. Then cut the gum above the tooth and peeled. Often have to cut the tooth into two parts, and maybe more. So it easier and safer to remove. When all pieces are removed, the hole is washed with antiseptic solutions. The wound edges should be sewn so that the healing came faster. The patient is given advice and prescribed antibiotics and anti-inflammatory. The treatment of pericoronitis may be over.
What can be complications, if not timely refer to a specialist
The processes that can occur because of pericoronitis very unpleasant. Some of them can transform into each other if the infection spreads quickly, or the patient never went to the dentist. Complications of pericoronitis when not treated:
- Abscess — pus formation in poznakomica space;
- Osteomyelitis spread to the bone tissue;
- An abscess is a limited area of the infection with formation of pus and destruction of the soft tissues;
- Phlegmon — purulent inflammation which has no clear boundaries. Can spread on pollitsa.
All these diseases are accompanied the body of intoxication — fever, weakness, dizziness, etc. So it is better not to bring to this state and to consult a doctor. The sooner the better and easier it will be. And even better often be checked in time to determine anything. The possibility of pericoronitis can be foreseen using the research renthenznimky. It’s not always accurate, but in most cases. And be sure to follow proper hygiene to prevent the complication of any disease.