Pain from wisdom teeth commonly arises in partially impacted wisdom teeth. Wisdom teeth are the last four teeth to erupt in the mouth. They emerge between the age of 17 to 24 years.
Wisdom tooth impaction occurs when there is not enough room for the teeth to emerge so they either erupt at an angle or partially erupt partly covered with the gums.
Pericoronitis can significantly affect the quality of daily life, making everyday activities difficult.
Causes of Impacted wisdom teeth infection
When a tooth emerges in the mouth the sterile space formed between the soft tissue covering the tooth and tooth is exposed to mouth bacteria.
The small pocket overlying the erupting tooth is difficult to clean. In addition, food can easily get trapped in this space, promoting bacterial growth and causing infection of the surrounding soft tissue.
Factors causing or aggravating the pain from wisdom teeth
Trauma from the upper teeth often exacerbates the symptoms of pericoronitis. As the upper third molar emerges, they bite onto the gum overlying the erupting lower third molars. Such repeated trauma can cause ulcerations or worsen the symptoms.
The presence of systemic disease can worsen or set off pericoronitis. Patients with impaired immune systems, such as those with uncontrolled diabetes or immunodeficiency disorders, can be more prone to developing impacted wisdom teeth infections.
Also, pericoronitis can be triggered or worsened by other systemic conditions that temporarily compromise the immune response. These include mental or physical stress, throat infection, or menstruation in females.
Wisdom teeth Affected By Infection
Research suggests that pericoronitis affects 4.92% of people between the age of 20 and 25 years and 95% of the infections are linked with the lower wisdom teeth.
It is commonly seen in people aged 20 to 29 years when the eruption of wisdom teeth tends to occur.
The incidence of the disease relies upon the wisdom teeth emerging positions.
Based on the space available for the teeth in the mouth they either come straight or an at an angle. They direction of angle either faces the second molars or away from it.
Straight or vertically emerging teeth are most likely to fully erupt and are least difficult to remove.
Wisdom teeth can also be lying horizontally in jaws. These teeth are the most difficult teeth to erupt and remove as they require extensive bone and soft tissue cutting.
Impacted wisdom tooth symptoms
Pain from wisdom teeth usually begin in the back of the lower jaw, near the emerging wisdom tooth. A combination of one or more symptoms described below indicates pericoronitis:
• Pain and swelling in or around the tooth at the back of the mouth
• Pain radiating to the surrounding structures.
• Symptoms get worse with function.
• Unpleasant taste
• Halitosis or bad breath
• Pus discharge
• Difficulty in opening mouth
• Difficulty swallowing
Treatment of wisdom tooth infection
There are a variety of treatment options to manage pain from wisdom teeth. Early recognition and initiating treatment to resolve signs and symptoms of pericoronitis is key to the successful management of the infection.
Scaling in and around the tooth to remove the impacted debris and decrease the bacterial load is the recommended first-line therapy for patients presenting with mild symptoms of pericoronitis.
Normal saline, water, chlorhexidine, and hydrogen peroxide can be used to irrigate the pocket between the gums and the tooth.
Maintaining good oral hygiene prevents the buildup of bacteria and food debris and is important in treating and preventing infection.
Pain from wisdom teeth can greatly limit day to day activities. Pain management, in addition to resolving infection, is crucial in pericoronitis.
Local anesthetic injections, pain relief gels, and painkillers relieve the symptoms of pain.
Antibiotics are advised if the spread of infection to the surrounding tissues is suspected.
Surgical removal of Soft tissue removal
Removing the infected soft tissues or gums can help resolve the infection. The soft tissue covering the erupting third molar can be removed to eliminate the deep pocket formed between the gums and the tooth.
Removal of the soft tissue covering the third molar also helps with tooth eruption. This treatment option is limited to the wisdom teeth that emerge in a straight or vertical position.
Removal of Wisdom tooth
After close examination and assessment, it appears that the tooth is not likely to emerge into a functional position and has an increased risk of persistent infection, extraction of the tooth can be considered.
Extraction of a tooth is the most likely solution to deal with the infection when the tooth does not have a favourable eruption position.
Pain from wisdom teeth arises in partially erupted wisdom teeth partly covered by gums.
Impacted wisdom teeth infection occurs as a result of food impaction and bacterial growth in the small pocket between gums (partially covering the tooth) and tooth.
Pain from wisdom tooth can significantly affect the quality of daily life.
If it is left untreated, it can progress to life-threatening infections, necessitating early identification, treatment, and prevention of the disease.