Acute pericoronitis
Acute Pericoronitis is swelling of the tissues around the crown of a tooth as it erupts into the mouth. Typically there is an operculum (gum flap) lying over the distal half of the tooth which can trap food and provides an environment favourable to bacterial growth, especially anaerobic organisms. Clinical signs and symptoms may include malaise; raised temperature; trismus (limited mouth opening); facial swelling; foul taste and nausea. Signs of dehydration may be present especially in warm weather.
There is a risk of spreading infection causing airway compromise therefore it is important to assess that risk by asking if the patient can swallow their own saliva and/or protrude their tongue. If they cannot then urgent admission to A&E is indicated.
Management of non-airway compromised infections is appropriate pain relief and advising rinsing the area with 0.2% chlorhexidine mouth rinse. In cases of spreading infection, not affecting the airway, but including trismus, raised temperature and/or facial swelling then it is appropriate to prescribe antibiotics in particular metronidazole.