Erupting tooth sometimes brings a lot of discomfort and problems to its owner. This applies to both children and adults suffering from the so-called wisdom teeth. One such problem is pericoronitis. This is the name of inflammation of the gums with incomplete or difficult eruption of a new tooth. The gum is formed above it into a kind of hood, partially or completely covering the young tooth. Treatment of pericoronitis mainly consists in excision of this formation. Let's take a closer look at the disease itself and the possibilities of its therapy.
International Classifier of Diseases
According to the old ICD-9, pericoronitis was code 523.3.
Now a new guide. Pericoronitis according to ICD-10 is divided into two forms:
- Sharp - 05.2.
- Chronic - 05.3.
Causes of pathology
Before analyzing the treatment of pericoronitis, consider the causes of its occurrence:
- Mechanical damage to the gums. Its source can be either the tooth itself or a foreign body in the mouth, chewing hard food. ATAs a result, in the area of the gums, where the tooth should soon appear, pieces of food, plaque begin to accumulate. All this attracts pathogenic microflora, whose vital activity causes the onset of the inflammatory process.
- Historical decrease in the dental arch of modern man by 1-1.5 cm compared to our ancestors. What is the risk? Not enough space for the last wisdom tooth. This leads to certain difficulties, which helps to eliminate only the treatment of pericoronitis.
- Individual conditions in which a wisdom tooth erupts. These can be thickened walls of the dental sac, thickened mucous membrane of the gum itself, reduced activity of growth factors of the tooth.
And one more feature - the wisdom tooth grows and the gum hurts. It may indicate that it does not grow vertically upwards, but at some angle to the gum. What is dangerous, he begins to put pressure on his neighbor, which ultimately leads to the destruction of the latter, as well as the spread of the inflammatory process not only to the soft tissue of the gums, but also to the bone tissue. Here it is already required not to excise the hood over the wisdom tooth, but to remove it, the destroyed neighbor.
A person can also be overtaken by an acute form of pericoronitis. It is dangerous with complications in the form of other pathologies: phlegmon of adjacent soft mandibular tissues, retromolar periostitis, abscess or osteomyelitis.
Symptoms of pathology
How do you know if you need treatment for pericoronitis? This inflammatorythe process manifests itself as follows:
- Pain in the gums in the area of teething. The pain increases markedly when chewing food, and sometimes when swallowing. May radiate to the ear or temple area.
- Swollen lymph nodes located under the lower jaw.
- Slight increase in body temperature - up to 37-37.5 degrees.
- It is difficult for the patient to open his mouth wide. Most often due to the fact that the process is accompanied by severe pain. Due to the fact that the inflammation has moved from the gums to the chewing muscles.
- Excision of the hood over the wisdom tooth is also required in the case when pus begins to be released when pressure is applied to this formation.
- Foul smell comes from the mouth. In addition, the patient feels an unpleasant aftertaste while eating. This is due to the periodic discharge of pus from the inflammatory focus.
Diagnosis of pericoroniaritis
When making a diagnosis, the dentist first of all considers the complaints of the patient himself. For example, "the wisdom tooth grows and the gum hurts." Then a visual and instrumental inspection takes place.
To track the position of the tooth itself in the thickness of the gums, an X-ray examination is performed. Based on all the data collected, the diagnosis of pericoronitis, the specialist prescribes the most appropriate treatment for the patient in his case.
At first symptoms
Sometimes the pain in the gums is so severe that the patient does not know how to live a few hours before surgery. Let's present a number of effectiveremedies to help alleviate the condition:
- Using baby teething ointments.
- Anti-inflammatory, sedative gels for adults - "Kamistad", "Cholisal".
- Treatment with Metrogyl Denta ointment or iodine solution for mucous membranes.
- Taking an anesthetic pill - "Analgin", "Ketanov", "Solpadein".
- Gum massage with clove essential oil.
Excision of soft tissue hood
The simplest treatment for pericoronitis in dentistry is the artificial removal of the resulting soft tissue hood over the wisdom tooth. The operation is quite simple: it takes about 20 minutes, it is performed under local anesthesia.
The event itself has two main goals:
- Remove the crease in the gum where food particles get stuck, creating a favorable environment for the reproduction of pathogens.
- "Free" the wisdom tooth, create space for the crown to erupt.
The removal of the hood over the wisdom tooth occurs approximately according to the following algorithm:
- Injected with a local anesthetic.
- The damaged gum is treated with an antiseptic composition. Most often it is miramistin or chlorhexidine.
- A diseased gum is excised with curved surgical scissors or a scalpel.
- Pus, plaque, food debris are cleaned with a speci altools, solutions.
- To stop the blood from damaged vessels, the doctor treats the wound with special medicines - "Kaprofer", "Kapromin" and so on.
- A tampon impregnated with an iodomorphic composition, usually at a 5% concentration, suitable for mucous membranes, is applied to the wound. Sometimes it is replaced with another anti-inflammatory agent. For example, patients with individual intolerance to iodine and products containing it.
Next, the patient will have a simple postoperative recovery:
- Regular visits to the dentist to monitor the healing process.
- Therapeutic baths with solutions of soda and s alt, which do not allow pathogenic bacteria to multiply in the wound.
- Taking antibiotics. The purpose of the event is the same - to suppress the rapid growth of pathogenic microorganisms in the wound.
Prognosis of treatment is favorable - inflammation subsides, a new tooth erupts. However, in rare cases, a new one may form in place of the removed hood. There is only one way out - tooth extraction.
Indications for wisdom teeth removal
Painful and complicated eruption of a wisdom tooth in rare cases ends with its removal. This is due to the long recovery of the patient after such an operation, intense pain.
Let's list the cases in which this tooth cannot be removed:
- Narrow dental arch. The specialist can come to such a conclusion as aftervisual examination, as well as on the basis of an x-ray. There is no space on the patient's jaw arch for new teeth to erupt. The new, in other words, simply has nowhere to squeeze in. Therefore, if the growing wisdom tooth is not removed, inflammation under the hoods on the gums will constantly disturb the patient.
- Incorrect development of the wisdom tooth. This specialist sees the results of an x-ray examination. The tooth can grow towards the neighbors, inside the jaw or towards the cheek. All this will be considered a pathological development, which entails a lot of complications. To avoid them, you need to eliminate the source of the problem.
- Pericoronitis affected the bone tissue of the wisdom tooth. The inflammatory process has moved from the gums to the tooth itself. Collapsing, it cannot develop and also leads to complications.
- Removal of the hood on the gum was unsuccessful. After a while, education reappeared in its original place.
Wisdom tooth removal for pericoronitis
Standard operation:
- The patient is given a local anesthetic.
- With the help of special tools, the tooth breaks out of its hole.
- The resulting wound is treated with antiseptic compounds.
In this case, great attention is paid to the postoperative recovery of the patient:
- Taking antibiotic tablets to prevent infection in the wound.
- Periodic antiseptic wound treatments. Most often, these are dental baths with a solution of chlorhexidine.
- Painkillers. Howas soon as the effect of the anesthetic injection stops (2-3 hours after the operation), in most patients the gums begin to hurt with such force that such drugs are indispensable.
Pain after surgery haunts the patient for several more days. The recovery period itself can take several months. It is also associated with taking expensive drugs. Because of this, this treatment method is used by dentists last.
Laser treatment
If inflammation is diagnosed at an early stage, painful and unpleasant surgery can be avoided. In modern times, an innovative method is used - laser therapy. Refers to conservative (non-surgical) treatment, is effective and completely painless. Laser treatment can relieve swelling, stop the inflammatory process, and have an analgesic effect.
Based on exposure to low intensity infrared radiation. It restores metabolism in tissues, accelerates blood flow to the site of inflammation, promotes the removal of toxins.
Successful treatment of pericoronitis requires at least 7-10 treatments. So, it is worth noting the following. Laser therapy today is not able to provide a complete unhindered eruption of the wisdom tooth, to correct its abnormal growth. Therefore, most often it has only an auxiliary meaning.
Home treatment of pathology
We note right away thatThe main treatment for pericoronitis is surgery. This is either excision of the soft tissue hood, or removal of an improperly growing wisdom tooth. Home remedies have only a temporary process. They are aimed at suppressing inflammation, relieving pain, but cannot eliminate the cause of the problem. Therefore, they are used before surgery in order to somehow alleviate the patient's condition.
When the gums are inflamed during the teething of a wisdom tooth, the following will be effective:
- Rinsing the mouth with anti-inflammatory solutions. These include formulations containing table or sea s alt, baking soda, furacilin.
- Decoctions of medicinal plants are quite effective in relieving inflammation. First of all, it is an infusion of calendula, chamomile, sage, nettle. They are not only famous for their antibacterial effect, but also help to reduce inflammation.
- Lubrication of the affected gums with an iodine-containing solution has a good effect. Make sure that it is applicable to mucous membranes. The patient should also have no contraindications to the use of drugs containing iodine.
- Old methods - applying a piece of lard, as well as rinsing with a peculiar solution: tea leaves with a crushed head of garlic.
It is worth abandoning folk methods for severe pain and a significantly elevated temperature. In this case, the patient requires the prompt provision of qualified medical care! Pericoronitis is dangerous because it can spread to bone tissue. An improperly growing wisdom tooth also contributes to this. Folk methods are completely powerless here - urgent surgical removal is required to avoid serious consequences.
Complications after treatment
After surgery (tooth extraction, excision of the hood), the following complications may develop:
- Opening bleeding at the site of the wound.
- Gum swelling.
- Slightly elevated body temperature.
- Swollen lymph nodes under the lower jaw.
- Pusal discharge, abscesses.
In general, discomfort haunts patients only in the first two days after surgery. However, if the pain does not want to subside, and the body temperature is consistently elevated, you should seek qualified medical help.
The most important causes of pericoronitis complications are the dentist's violation of the rules for proper wound decontamination and the patient's low immunity.
Preventive measures
If after excision of the hood on the gum, recovery can be trouble-free, then the removal of a wisdom tooth always needs to continue treatment. The patient feels pain for a long time after the operation, he needs medication to return to normal.
To notice such a problem in time or avoid it altogether, just follow a few simple tips:
- Don't forget to go to the dentist twice a year for preventive check-ups. The specialist will notice the emerging problem with the teeth in time. And this is not onlywill simplify, but also reduce the cost of subsequent treatment.
- Pay attention to dental and oral hygiene. It is best if you choose a toothbrush and paste on the recommendation of your doctor. An overly soft/hard brush or toothpaste that irritates the gums can also lead to the development of such a serious disease as pericoronitis.
- Purchase a special device - an irrigator. It allows you to clean your teeth even in the most inaccessible areas. An irrigator is also best to choose based on the recommendations of your dentist.
Pericoronitis is a disease that can only be de alt with surgically. Other methods are aimed only at eliminating the symptoms. In mild cases, the patient is prescribed excision of the hood on the gum, in pathological cases, the removal of a wisdom tooth.
