An Insight into Acute Pericoronitis and the Need for an Evidence-Based Standard of Care

Chelsea Wehr, Gianncarlo Cruz, Simon Young, Walid D Fakhouri, Chelsea Wehr, Gianncarlo Cruz, Simon Young, Walid D Fakhouri

Abstract

Background: Pericoronitis is inflammation of the operculum associated with a partially erupted third molar. It is a highly prevalent infection of the oral cavity and presents as a painful sensation of the soft tissue encompassing the crown of the involved tooth. Though pericoronitis is common, there is no evidence-based standard-of-care for treatment of emergency patients with acute pericoronitis. Study Design: In this study, anonymous clinicians were asked to participate in an online survey with questions formulated to identify professional clinical background, emergency treatment preferred for acute pericoronitis, number of associated complications, frequency of third molar extraction, and patient satisfaction. Results and Conclusion: A statistical analysis of the collected data regarding the variance among different treatment plans and associated complications revealed little consensus in the treatment of pericoronitis. The lack of consistency of the responses focusing on the preferred treatment for emergency patients with acute pericoronitis reinforces the need for developing a standard-of-care to train future dental professionals based on well-designed randomized controlled clinical trials and meta-analyses. Practical Implications: The ultimate goal is developing a treatment option with the fewest complications to provide the best health care for patients with pericoronitis. This issue is seen not only as an acute infection but also has the potential to impact overall health.

Keywords: antibiotics; emergencies; evidence-based dentistry; gingivitis; third molar.

Conflict of interest statement

The authors declare that they do not have any financial, economic or professional conflict of interests that may have influenced the design, execution or presentation of this study.

Figures

Figure 1
Figure 1
Survey results and data analysis of (A) providers indicate their preferred method of treatment for emergency patients presenting with acute pericoronitis of third molars. Prescribing antibiotics and scheduling a follow up appointment was reported as the most common treatment option. (B) Providers indicated which treatment most satisfies patient expectations on the initial emergency appointment with acute pericononitis. (C) The pie chart refers to the number of days to wait for a follow-up after prescribing antibiotics. The follow up timeline varied between providers. About 33.77% of dentists, a majority in this study, indicated that the preferred method of treatment for pericoronitis is antibiotic prophylaxis with follow up scheduled three-to-four days for treatment or surgery.

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Source: PubMed

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