Clinical picture, risk factors and management of pericoronitis in children

Abstract

Pericoronitis is an inflammatory condition of the soft tissues surrounding a partially erupted tooth, commonly associated with the eruption of permanent molars. While it is more frequently reported in adolescents and adults, children are not exempt from its occurrence, particularly during the mixed dentition phase. In pediatric patients, the clinical presentation can vary widely, ranging from mild gingival discomfort to more severe symptoms such as swelling, trismus and lymphadenopathy. These manifestations are often misinterpreted as routine teething issues or gingivitis, leading to delayed recognition and management. The unique anatomical and behavioral factors present in children significantly influence the risk profile for pericoronitis. Immature gingival tissue, limited space for erupting molars, poor oral hygiene and uncoordinated brushing habits all contribute to the accumulation of debris and bacterial plaque beneath the operculum. Dietary habits rich in fermentable carbohydrates and insufficient caregiver awareness further heighten the risk. In some cases, systemic health conditions or immunosuppression may alter the inflammatory response, complicating diagnosis and prolonging healing. Management strategies in children must account for their developmental stage, level of cooperation and overall health. Conservative treatments such as irrigation, improved oral hygiene and analgesics are commonly effective in early cases. In more advanced or recurrent presentations, antibiotics or minor surgical interventions like operculectomy may be necessary. Laser-assisted procedures offer advantages in pediatric settings by minimizing discomfort and improving healing. Across all treatment options, preventive care and caregiver education are vital to reducing recurrence and improving outcomes. Understanding the clinical diversity, risk factors and treatment responses in children is essential for early detection and effective management of pericoronitis. Pediatric-focused approaches that integrate preventive strategies, timely intervention and interdisciplinary care can significantly reduce the burden of this condition during critical stages of dental development.