Sore, swollen gum at the back
The gum behind or over the last lower tooth is red, puffy and tender, and may be painful to bite on.
Wisdom tooth gum infection
Pericoronitis: Swollen, Painful Gum Over a Wisdom Tooth
When a wisdom tooth is only partly through, the flap of gum over it can trap food and bacteria and become inflamed. Most flare-ups settle with cleaning; repeated ones are a reason to consider removal.
- 3D CBCT imaging for wisdom teeth
- Oral & maxillofacial surgeon on the team
- Open daily 10:00–20:00
If you have had wisdom tooth X-rays elsewhere, bring them or send them before the visit.
Quick answer
What is pericoronitis?
Pericoronitis is inflammation, often with infection, of the gum around a wisdom tooth that has only partly come through. Food and bacteria collect under the flap of gum covering the tooth, causing swelling, pain at the back of the mouth, a bad taste and sometimes difficulty opening. At Creative Arts in Dubai it is treated by cleaning under the flap, with antibiotics only when infection is spreading; repeated episodes are usually a reason to remove the tooth.
Who treats you here Dr. Firas Osman Oral & Maxillofacial Surgeon & Implantologist · Dr. Khalid Saeed Co-founder & Dentist · Dr. Somar Dahdal General Dentist
Every dentist’s licence can be checked on the DHA Sheryan medical directory.
27 yearsIn-house dental laboratory in the same building
Written planItemised treatment plan before you commit
Open daily10:00–20:00, seven days a week
Jumeirah 3614 Jumeira St, Umm Suqeim 1, Dubai
Symptoms
What does pericoronitis feel like?
It usually affects a lower wisdom tooth and often flares when you are tired, run down or unwell.
Bad taste or smell
Trapped food and bacteria under the flap cause an unpleasant taste or breath, sometimes with pus.
Pain spreading to the ear or throat
The ache can radiate along the jaw, to the ear or down towards the throat, making swallowing uncomfortable.
Difficulty opening the mouth
Inflammation near the jaw muscles can make it hard to open wide. This stiffness is called trismus.
Causes
Why does the gum over a wisdom tooth swell?
Wisdom teeth are the last teeth to come through, usually in the late teens or twenties, and often there is not quite enough room for them. A tooth that is stuck part way leaves a flap of gum (the operculum) covering part of its biting surface. The space underneath is almost impossible to clean with a toothbrush, so food and plaque bacteria collect there.
Most of the time the body keeps this in check. A flare-up tends to happen when something tips the balance: food packed under the flap, an upper tooth biting on and bruising the gum, or a period of illness, stress or poor sleep. The gum becomes inflamed and swollen, which makes the flap bigger and easier to bite on, and the cycle continues.
Pericoronitis is a gum problem, but it is closely linked to the position of the tooth. A wisdom tooth that is impacted, tilted against the tooth in front or only partly through is more likely to cause repeated episodes than one that has erupted fully into a normal position. The NHS lists gum infection around wisdom teeth among the problems that can lead to their removal.
Seek urgent help if…
Go to a hospital emergency department straight away if swelling spreads into the cheek, under the jaw or down the neck, you have a fever and feel unwell, you are struggling to swallow or breathe, or you can barely open your mouth and it is getting worse. These can be signs that the infection is spreading beyond the gum; the NHS gives the same advice for dental infections. For pain and swelling limited to the gum, contact the clinic during opening hours, 10:00 to 20:00 daily; there is no overnight service.
Until you are seen
What can you do at home for a swollen gum over a wisdom tooth?
Home care does not replace an examination, but it can ease symptoms for a day or two until your appointment:
- Rinse with warm salt water several times a day, especially after eating, swishing it gently around the back of the mouth.
- Keep brushing the area with a soft brush, even if it bleeds a little. Leaving it alone allows more plaque to build up.
- Use over-the-counter pain relief as directed on the pack or by your pharmacist.
- Eat soft food and chew on the other side.
- Do not smoke, which slows healing of the gum.
Avoid putting crushed tablets or strong substances on the gum, which can burn it, and do not use leftover antibiotics. If the swelling is spreading or you are developing a fever, do not wait for home care to work.
Diagnosis
How is pericoronitis diagnosed?
The diagnosis is usually clear from an examination. X-rays show what the tooth is doing underneath.
History and examination
The dentist asks when it started and whether it has happened before, then examines the gum flap, the opposing tooth and the glands under the jaw.
Visit 1X-ray of the tooth
A panoramic or local X-ray shows whether the wisdom tooth is impacted, how it is angled, and whether there is decay in it or the tooth in front.
Visit 13D CBCT scan if removal is planned
When the roots of a lower wisdom tooth appear close to the nerve, a CBCT scan shows the relationship in three dimensions before surgery.
When neededA plan for now and later
You leave with treatment for the current flare-up and an explanation of whether the tooth can be kept, monitored or should be removed.
Visit 1
Treatment options
Pericoronitis treatment, from simple to definitive
The first options treat the flare-up. The last ones deal with the reason it keeps coming back.
| Option | When it fits | What to expect |
|---|---|---|
| Cleaning and irrigation under the flap | Every flare-up | The area under the gum is gently flushed and cleaned, with local anaesthetic if it is very tender; relief often follows within a day or two |
| Short course of antiseptic rinse | Alongside cleaning, if your dentist recommends it | Used for a limited time as instructed; long-term use can stain teeth |
| Adjusting or removing the upper wisdom tooth | When an upper tooth bites on the swollen flap | Smoothing the upper tooth or removing it if it has no opposing tooth to work with |
| Antibiotics | Only with spreading swelling, fever or other signs of wider infection | Prescribed by the dentist when indicated; they do not stop the problem returning |
| Removing the gum flap (operculectomy) | Selected cases where the tooth is upright and has room to erupt fully | May be considered in some cases; the flap can grow back |
| Wisdom tooth removal | Repeated episodes, a tooth that cannot erupt properly, or decay or damage to the neighbouring tooth | Planned once the acute inflammation has settled; see wisdom tooth removal |
In the UK, NICE guidance on the extraction of wisdom teeth states that a first episode of pericoronitis, unless particularly severe, should not in itself be an indication for surgery, while second or subsequent episodes should be. Read more on wisdom tooth removal at Creative Arts.
What not every case needs
Does every case of pericoronitis mean the tooth must come out?
No. The decision depends on the tooth's position and how often the gum flares, not on a single painful episode.
Keeping and monitoring may be reasonable when
- It is the first, mild episode and it settled quickly with cleaning
- The tooth is upright and still has room to come through fully
- You can clean the area well once the swelling has gone
- X-rays show no decay or damage to the tooth in front
Removal is usually discussed when
- Episodes keep coming back, or one was severe
- The tooth is impacted or tilted and cannot erupt normally
- There is decay in the wisdom tooth or the neighbouring molar
- Food packing or gum pockets keep forming behind the second molar
Who treats you
Who treats pericoronitis at Creative Arts
Dr. Firas Osman, Oral & Maxillofacial Surgeon & Implantologist, assesses and removes complex and impacted wisdom teeth. Dr. Khalid Saeed and Dr. Somar Dahdal treat flare-ups and carry out extractions at the clinic.
Sources
Clinical statements on this page are consistent with these independent sources. They describe averages from studies, not a promise for any one patient.
- National Institute for Health and Care Excellence. Guidance on the extraction of wisdom teeth (TA1). NICE, 2000.
- NHS. Wisdom tooth removal. NHS.
- NHS. Dental abscess. NHS.
Patient questions
Frequently asked questions
Can pericoronitis go away on its own?
A mild flare-up can settle with careful cleaning and salt-water rinses, but the flap of gum and the trapped space underneath remain, so it often comes back. Having the area professionally cleaned shortens the episode and lets the dentist check the tooth position on an X-ray. Spreading swelling or fever should never be left to settle on its own.
Is pericoronitis an emergency?
Gum swelling and pain limited to the area around the wisdom tooth is usually urgent but not an emergency, and should be seen within a day or two. It becomes an emergency if swelling spreads into the cheek or neck, you have a fever, you are struggling to swallow or breathe, or you can barely open your mouth. Then go to a hospital emergency department.
Do I need antibiotics for pericoronitis?
Not always. Most flare-ups respond to cleaning under the gum flap and good home care. Antibiotics are prescribed when there are signs of spreading infection, such as facial swelling, fever or swollen glands, or for medical reasons. They calm the infection but do not remove its cause, so the problem can return once the course ends.
Should a wisdom tooth be removed after pericoronitis?
Not necessarily after a single mild episode, especially if the tooth is upright and still erupting. Removal is usually recommended when pericoronitis keeps returning, when one episode was severe, or when the tooth is impacted and cannot come through properly. The decision is made with an X-ray, and with a CBCT scan if the roots are close to the nerve.
Can I have a wisdom tooth removed while the gum is still swollen?
Usually the acute inflammation is treated first, then the extraction is planned a little later when the swelling has settled and you can open your mouth comfortably. This tends to make the surgery easier and the recovery smoother. Your surgeon decides the timing based on how severe the infection is.
Why does pericoronitis keep coming back?
Because the cause stays in place: a tooth that is only partly through, with a gum flap that cannot be cleaned underneath. Each time food and bacteria build up, or you are run down, the gum can flare again. If episodes are repeating, ask about the long-term options, including removal of the tooth, rather than treating each flare-up alone.
Keep exploring
Related treatments
Wisdom teethWisdom tooth removalAssessment, 3D planning, surgery and recovery.GuideDo wisdom teeth need removing?When to remove and when to keep and monitor.ConditionImpacted teethWisdom teeth and canines that cannot come through.GuideBefore wisdom tooth surgeryHow to prepare for the day of the operation.CostWisdom tooth removal costWhat decides the cost of removing a wisdom tooth.UrgentSwollen face from a tooth infectionWhen facial swelling needs emergency care.
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One clinic, in Jumeirah 3 / Umm Suqeim 1
Creative Arts has a single clinic on Jumeira Street (Jumeirah Beach Road). Ask about parking when you book.
- Address614 Jumeira St, Jumeirah 3, Umm Suqeim 1, Dubai
- Opening hoursDaily 10:00–20:00, including Friday and Sunday
- Neighbouring areasJumeirah 1–3, Umm Suqeim 1–3, Al Wasl, Al Safa, Al Manara
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- Address614 Jumeira St, Jumeirah 3, Umm Suqeim 1, Dubai · Our clinic in Jumeirah 3 / Umm Suqeim 1
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