Skip to main content Skip to footer

Acute pericoronitis (including erupting teeth in children)

Print this page

Brief description of the condition

Infection or inflammation of the operculum (i.e. the gingiva [gum] tissue covering a partially erupted tooth). Pain associated with erupting teeth in children (both primary and permanent teeth). 

Key signs and symptoms

  • Pain (usually well-localised around a partially erupted tooth)
  • Swelling (swelling of the gingiva around a partially erupted tooth; can extend to facial swelling, especially with lower molar tooth)
  • Discomfort with swallowing
  • Limited mouth opening
  • Unpleasant taste or odour from the affected area
  • Fever
  • Nausea
  • Fatigue

Note that pericoronitis in third molars and temporomandibular disorder (TMD; see Acute temporomandibular disorder) can present with similar symptoms (pain and limited mouth opening) and a diagnosis of TMD should be considered for a partially erupted third molar with no signs of infection.

Initial management

Determine if the airway is compromised. Symptoms include: difficulty breathing; high pitched breathing sound (stridor); difficulty swallowing (dysphagia); hoarse or muffled sounding voice (dysphonia).

If the airway is compromised, send the patient immediately to emergency medical care at the nearest emergency department or call 999.

If the airway is not compromised:

For adults

  • Recommend optimal analgesia (see Analgesia).
  • Do not prescribe antibiotics unless there are signs of spreading infection (e.g. limited mouth opening, facial swelling), systemic infection, or judged appropriate for an immunocompromised patient.29
  • Advise the patient to rinse their mouth with salt water or 0.2% chlorhexidine mouthwash.
  • Advise the patient to seek urgent dental care or, if the pain is controlled with analgesia, non-urgent dental care.

For children:

  • Advise optimal analgesia, soft tooth brushing around affected area and rinsing the mouth after food.

Subsequent care

For adults, consider:

  • Ultrasonic scaling and/or debridement to remove any foreign body lodged around the partially erupted tooth, under local anaesthesia, where possible.
  • Irrigating under damaged tissue.
  • Extracting the tooth in severe cases or where there are repeated episodes of pericoronitis associated with the same tooth.30
  • Extracting or adjusting an opposing tooth where there is trauma to the inflamed operculum if the position of the tooth suggests that it is unlikely to achieve function in future.