Pericoronitis is a complication caused by the eruption process of a tooth and is mainly manifested as inflammation of the soft tissues surrounding the crown. It is most commonly seen in the mandibular third molars (commonly known as wisdom teeth). It can also occur in the maxillary third molars. The disease occurs mostly between the ages of 18 and 30. The initial stage of pericoronitis is just a painful redness of the gums, which is aggravated during chewing and swallowing, and there may be increased pain in opening the mouth, and when the infection spreads to the chewing muscles and pterygoid muscles, there may be dental closure. Local swelling may occur, and the lymph nodes may increase in size and pressure. Systemic symptoms, such as general malaise, fever and increased white blood cells, may appear at this time. Li Baokui, Department of Stomatology, Baoji Second People’s Hospital If the pain does not stop and the fever does not subside in 2 to 3 days, the inflammation can be considered to have developed to the septic stage. If the inflammation is drained by incision in this period, the inflammation will gradually subside. If the infection is not controlled at this stage, the inflammation will spread and the infection can spread to the chewing muscle, cheek, parapharynx and mandible causing interstitial infection in the corresponding gap. And can further cause a variety of serious complications. Diagnosis 1. Most often occurs in young people, especially in 18 to 25 years old. There is a history of systemic triggering factors or recurrent attacks. 2. In the early stage of acute pericoronitis, there is usually no obvious systemic reaction, and the patient feels distension and discomfort in the affected area, and the pain increases when chewing, swallowing and opening the mouth. The examination reveals swelling in the posterior region of the interrupted tooth and molar, and purulent secretions in the pericoronal pocket. 3. Further development of inflammation, involving the occlusal and pterygoid muscles, swelling of the mandibular angle area, accompanied by varying degrees of mouth opening restriction or even inability to open the mouth. Systemic symptoms are obvious, often with submandibular lymph node enlargement and pressure pain. If not treated reasonably in time, it may develop into pericoronal abscess, maxillofacial cellulitis or even osteomyelitis. 4. Chronic pericoronitis may form a fistula on the buccal side of the mandibular first molar, or a skin fistula on the anterior margin of the occlusal muscle. Third, treatment According to the clinical examination with the third molar, X-ray dental film can be taken to confirm the clinical manifestations, it is not difficult to make a diagnosis. Sometimes there is a fistula at the gingival-buccal groove of the mandibular first molar in the vestibule of the oral cavity as a result of subperiosteal abscesses invading the anterior margin of the chewing muscle, which is weak in resistance, during acute inflammation. Care should be taken at this point not to misdiagnose the infection as an infection of the mandibular first molar. Early treatment of pericoronitis should control the local bacterial infection, and local treatment is important. The gingival pocket can be rinsed with 3% hydrogen peroxide or 1:5000 potassium permanganate solution, and then coated with iodine glycerin or rehabilitative new solution. Patients can be given a gargle to rinse their mouth several times a day. Maintain oral hygiene. Also give antibiotic treatment, as its common causative organism is Staphylococcus aureus and anti-S. aureus antibiotics should be used. If the abscess is confined, it should be drained by incision under local anesthesia. After anti-inflammatory treatment, the pathogenic tooth should be extracted. If there is a long-standing fistula, the granulation tissue in the fistula must be scraped out at the same time as the tooth is extracted. If the molar is in a normal position and there is an opposing tooth, the gingival flap can be removed to eliminate the blind pocket. However, sometimes this method is not effective, and for patients with recurrence, the affected tooth still needs to be extracted. Prevention and control measures The main treatment of pericoronitis is to enhance the resistance of the patient’s body, control the infection and promote the dissipation of inflammation. After the acute phase, surgical treatment of the diseased tooth should be considered to prevent recurrence.