From the Guidelines
The treatment for pericoronitis or gingivitis primarily involves addressing the underlying infection and inflammation, with a focus on improved oral hygiene and the use of antimicrobial mouthwashes, such as those containing green tea or turmeric, which have been shown to be as effective as chlorhexidine in reducing plaque and gingivitis levels 1. For pericoronitis, treatment includes:
- Thorough cleaning around the affected wisdom tooth
- Warm salt water rinses (1/2 teaspoon salt in 8 ounces of warm water) 4-6 times daily
- Careful brushing and flossing
- Antibiotics such as amoxicillin (500mg three times daily for 7 days) or clindamycin (300mg four times daily for 7 days) for penicillin-allergic patients may be prescribed for severe infections
- Pain can be managed with ibuprofen (400-600mg every 6 hours) or acetaminophen (500-1000mg every 6 hours) For gingivitis, treatment focuses on:
- Improved oral hygiene including brushing twice daily with fluoride toothpaste
- Daily flossing
- Using an antimicrobial mouthwash containing green tea or turmeric, which have been shown to be as effective as chlorhexidine in reducing plaque and gingivitis levels 1
- Professional dental cleaning (scaling) is essential to remove plaque and tartar buildup These treatments work by reducing bacterial load, decreasing inflammation, and allowing gum tissues to heal. In severe or persistent cases of pericoronitis, surgical removal of the wisdom tooth may be necessary, while untreated gingivitis can progress to more serious periodontal disease, so prompt treatment is important. Some studies also suggest that other natural products such as lemongrass oil 1 and polyherbal products 1 may be effective in reducing plaque and gingivitis levels, although more research is needed to confirm their efficacy.
From the Research
Treatment for Pericoronitis
- The treatment for pericoronitis involves local measures, and in some cases, the removal of the impacted tooth may be necessary 2.
- There is no evidence-based standard of care for the treatment of emergency patients with acute pericoronitis, and a statistical analysis of collected data revealed little consensus in the treatment of pericoronitis 3.
- Evidence-based recommendations for pericoronitis management suggest local therapy over antibiotic prescribing, which should be reserved for severe conditions 4.
Treatment for Gingivitis
- For chronic periodontitis, a study found that amoxicillin and metronidazole administered immediately after completion of full-mouth periodontal debridement significantly improved the 6-month clinical outcomes 5.
- A systematic review and meta-analysis found that adjunctive Amoxicillin-plus-Metronidazole to full-mouth scaling and root planing in periodontitis showed a beneficial effect with higher drug dose for clinical attachment level gain and periodontal pocket depth reduction 6.
Antibiotic Use
- The use of antibiotics for pericoronitis is abundant and often unnecessary, with almost 75% of dentists prescribing antibiotics for pericoronitis, and pericoronitis being among the top 4 in the frequency of antibiotic use 4.
- The most prescribed antibiotics for pericoronitis are amoxicillin and metronidazole 4.