
Lower Wisdom Tooth Was Sore. Diagnosed As Pericoronitis. On Pencillin. Suggest The Treatment?

Surgery only if severe infection
Detailed Answer:
Hi XXXX,
Thanks for writing in to us.
Pericoronitis is a dental disorder in which the gum tissue around the molar teeth becomes swollen and infected. This disorder usually occurs as a result of impacted or partially erupted wisdom teeth, the third and final set of molars that most people get in their late teens or early twenties.
Pericoronitis can develop when wisdom teeth only partially erupt (break through the gum). This allows an opening for bacteria to enter around the tooth and cause an infection. In cases of pericoronitis, food or plaque (a bacterial film that remains on teeth after eating) may get caught underneath a flap of gum around the tooth. If it remains there, it can irritate the gum and lead to pericoronitis. If the pericoronitis is severe, the swelling and infection may extend beyond the jaw to the cheeks and neck.
If the pericoronitis is limited to the tooth (for example, if the pain and swelling has not spread), treat it by rinsing your mouth with warm salt water. You should also make sure that the gum flap has no food trapped under it.
If your tooth, jaw and cheek are swollen and painful, treatment of the infection with antibiotics (usually penicillin group of antibiotics, unless you are allergic) is advised. You can also take pain relievers such as aspirin paracetamol or ibuprofen.
If the pain and inflammation are severe, or if the pericoronitis recurs, oral surgery to have the gum flap or wisdom tooth removed may be necessary. You can wait for a while before surgery if your symptoms are not severe and subside with medication.
I hope this helps.
Do write back in case of doubts.
Dr.A.Rao Kavoor


Probiotics is optional
Detailed Answer:
Hi XXXX,
Thanks for writing in with an update.
I am glad to hear that the soreness has subsided and you are doing well. At the moment I would suggest you to take proper care of your dental hygiene and do salt water gargle regularly.
Probiotics may be considered as an optional for your condition. As per reseaarch on probiotics and oral health done in 2010, following conclusion has been drawn:
The interest in oral probiotics has been growing during the last decades. Most of the studies have been conducted with probiotic strains originally suggested for gut health; however, it is important to realize that each of the suggested health benefits should be studied for each bacterial strain individually. Thus, a probiotic bacterium in the mouth is not necessarily an oral probiotic. Furthermore, it is quite possible that the same species are not optimal for all oral health purposes; e.g., different properties might be desired in respect to dental and gingival health.
At least some of the probiotic bacteria used in various probiotic products may colonize the oral cavity during the time they are in use; thus, the effects of probiotic bacteria in the oral cavity are important to understand. Probiotic bacteria seem to affect both oral microbiota and immune responses. On the other hand, the extent to which bacteria in food or in food ingredients can influence relatively stable oral microbiota is difficult to predict. Thus, both research to unravel the mechanisms of possible probiotic action and long-term clinical trials are needed if probiotics are to provide a new scientifically proven means of preventing or treating oral diseases.
Several health-promoting effects of probiotic bacteria are well documented, and there is no reason to restrict the use of probiotic products because their effects on oral health are not yet well understood; however, their recommendation for dental health purposes is not yet justified.
Your mild loose motion might be a side effect. It is strongly recommended you eat healthy food and drink adequate amounts of water and fluids.
I hope this helps.
Do write back in case of doubts.
Dr.A.Rao Kavoor


Please find detailed answer below
Detailed Answer:
Hi XXXX,
You are welcome and thanks again for your update.
As you might have heard from your dentist, Pericoronitis can recur in many patients and at the same time 2 months is relatively a short period and you are taking proper measures to maintain dental hygiene. With these is place, there is little reason to worry.
If you develop pain, fever, discomfort and the swelling that extends beyond the jaw to the cheeks and neck, then you must report to your doctor immediately. Other than this there is no reason to worry. Please make sure that you take treatment from a dentist when in India, even if you do not have any pain or swelling.
I hope this helps.
Do write back in case of doubts.
Dr.A.Rao Kavoor


Crest Pro-Health can cause few side effects
Detailed Answer:
Hi XXXX,
You are welcome and thanks again for your update.
Humorous it may seem but I think there is a lot of controversy in using Crest Pro-Health mouthwash. It can cause burns in tongue/ inner lips as you have mentioned and also loss of taste sensation.
Reports also say that it contains Cetylpyridinium chloride, or CPC, is an antiseptic ammonium compound found in small amounts and can stain teeth in some people using it.
Please be careful of the skin peeling and stop using it if symptoms persist and/ or worsen.
I hope this helps.
Do write back in case of doubts.
Dr.A.Rao Kavoor


Right step taken by you
Detailed Answer:
Hi XXXX,
You are welcome and thanks again for your update.
I think you are doing the right thing by taking enough precautions for your problem. Please consult your doctor tomorrow and have a review clinical examination and explain all your problems including the side effects to him.
Take care.
Wishing you good health.
I hope this helps.
Do write back in case of doubts.
Dr.A.Rao Kavoor


Apparently, when I went for the second opinion, I expected something serious to be said about my wisdom tooth. It turned out that the infection of my wisdom tooth had been greatly reduced (the dentist said the gums although swollen, were not hurting anymore, and the infection, if any, must have been previously minor; two months theoretically was sufficient time to plan for the surgery); the ulcers were actually fungal infections candidiatis, caused by the combination of crest mouthwash and the penicillin that I was having. I was advised to immediately discontinue taking the antibiotic; the dentist said if another such wisdom tooth infection occurs, he would prescribe another antibiotic, a different, less potent one. But two months should be okay, he said. That's the difference between oral surgeons and dentists; I should have first referred to the latter to save all this trouble. This is ridiculously frustrating...
You can wait two months
Detailed Answer:
Hi XXXX,
Thanks for writing in with an update.
Well, first of all we can relax, as I have said earlier, two months is relatively a short period of time and the wisdom tooth infection has been controlled and this is confirmed through the second opinion. I understand your frustration at being told to go in for a surgery right away.
I suggest you do plain salt water gargle if you continue to have troublesome ulcers. In case you have to stop using crest mouthwash due to persistence of ulcers, you may continue to rinse your mouth after meals and at night. Use water or 0.9% sodium chloride solution (saline or salt water). You can make a fresh sodium chloride solution for each rinse by dissolving half a teaspoon of salt in 250 ml of fresh water. Use cool or warm water - whatever your prefer.
There are many newer antibiotics which will work well for your condition should it happen again. With the amount of care you are taking, I do not see any infection happening again, at least not in the next two months.
Concerning the ulcer healing, you may allow somewhere between 3 to 5 days before things should get normal for you.
I hope this helps.
Do write back in case of doubts.
Dr.A.Rao Kavoor


Once again, I humbly thank you for your help, and I shall certainly write back if there is anything I would like to share of any importance.
Welcome
Detailed Answer:
Hi XXXX,
You are most welcome and I am glad to have been able to answer your queries.
As your dentist has rightly said, the salt water gargle will help the most, at the moment.
I would be glad to hear updates concerning your condition and answer further query should you have any.
Thanks,
Dr.A.Rao Kavoor


No antibiotic resistance
Detailed Answer:
Hi XXXX,
Thanks for writing in with an update.
There is no need to worry for antibiotic resistance. I am sure that you take antibiotics only when necessary. It happens in people who take self medication and abuse antibiotics.
I agree that taking care of the fungi is important. Please discuss the matter with the dentist.
I hope this helps.
Do write back in case of doubts.
Dr.A.Rao Kavoor

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