Understanding and Treating Gum Flaps Over Wisdom Teeth

Wisdom teeth, the last to emerge, often present unique challenges. One such problem is the formation of an operculum, a flap of gum tissue that develops over a partially erupted tooth. This condition, though common, can lead to significant discomfort and, if left unaddressed, infection. An operculum typically forms when wisdom teeth, especially lower third molars, lack sufficient space to fully erupt through the gums. The presence of this gum flap can be particularly uncomfortable, exacerbated if an opposing upper tooth puts pressure on it. Beyond discomfort, an operculum creates an ideal environment for infection. This complication, known as operculitis or pericoronitis, arises because the area beneath the flap is difficult to clean, allowing plaque and bacteria to accumulate. This leads to inflammation and infection, most commonly affecting individuals between 20 and 29 years old. Factors like pregnancy and fatigue may also increase susceptibility. While some individuals may be asymptomatic, others experience clear signs of pericoronitis. These include swelling, pain or discomfort when biting, an unpleasant taste or smell, and pus discharge. In severe cases, the infection can spread to the throat and neck, underscoring the importance of early intervention. Treatment for an infected operculum typically begins with clearing the infection. Your dentist will clean the affected area and may prescribe an antibacterial mouthrinse or antibiotics. Following this, your dentist will assess the tooth's eruption. If the tooth isn't emerging correctly, or if the infection is severe, a minor surgical procedure called an operculectomy may be recommended to remove the gum flap. Operculectomy can be performed using traditional surgical methods or laser-assisted surgery. Laser surgery is increasingly favored due to its potential for faster completion and shorter healing times, offering a clean and efficient removal method. Regardless of the technique, a local anesthetic will be administered for patient comfort. Post-operative care usually involves rinsing with warm salt water, avoiding irritating foods, and applying topical antibiotics. A follow-up appointment will be scheduled to monitor healing. In some instances, the gum flap may regrow. In such cases, your dentist might discuss further options, such as wisdom tooth extraction, to prevent recurrent infections. If you notice any signs of discomfort or your wisdom teeth beginning to emerge, prompt consultation with your dentist is always advisable.