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Pericoronitis is inflammation of the soft tissues surrounding the crown of a partially erupted tooth, [1] including the gingiva (gums) and the dental follicle. [2] The soft tissue covering a partially erupted tooth is known as an operculum, an area which can be difficult to access with normal oral hygiene methods.
Putting pressure or warmth on the tooth may induce extreme pain. The area may be sensitive to touch and possibly swollen as well. This swelling may be present at either the base of the tooth, the gum, and/or the cheek, and sometimes can be reduced by applying ice packs. An acute abscess may be painless but still have a swelling present on the gum.
Periapical periodontitis may develop into a periapical abscess, where a collection of pus forms at the end of the root, the consequence of spread of infection from the tooth pulp (odontogenic infection), or into a periapical cyst, where an epithelial lined, fluid-filled structure forms.
An abscess is a localized collection of pus which forms during an acute infection. The important difference between a periapical abscess and abscesses of the periodontium are that the latter do not arise from pulp necrosis. [12] Abscesses of the periodontium are categorized as gingival abscess, periodontal abscess and pericoronal abscess.
Green arrows indicate tooth decay. Blue arrows indicate abscess at root of tooth. The infection at the root of the tooth can travel through bone and infect surrounding soft tissue. Mouth infections are usually diagnosed on history and physical exam in the dental office or at a clinic visit with an otolaryngologist. [1]
Sometimes the symptoms reported in the history are misleading and point the examiner to the wrong area of the mouth. For instance, sometimes people may mistake pain from pulpitis in a lower tooth as pain in the upper teeth, and vice versa. In other instances, the apparent examination findings may be misleading and lead to the wrong diagnosis ...
This infection is what causes necrosis of the pulp. [4] Larger cysts may cause bone expansion or displace roots. Discoloration of the affected tooth may also occur. Patient will present negative results to electric and ice test of the affected tooth but will be sensitive to percussion. Surrounding gingival tissue may experience lymphadenopathy.
Periodontal abscesses may be difficult to distinguish from periapical abscesses. Since the management of a periodontal abscess is different from a periapical abscess, this differentiation is important to make (see Dental abscess#Diagnostic approach) For example, root canal therapy is unnecessary and has no impact on pain in a periodontal abscess.