Clinical Manifestations
The classic presentation is severe pain around an erupting lower wisdom tooth, radiating to the ipsilateral ear, throat, and temporal region.
Examination reveals an erythematous, edematous operculum from which pressure may express purulent exudate. The overlying tissue is extremely tender to palpation.
Trismus is a hallmark finding, ranging from mild (limited opening) to severe (<10 mm interincisal distance), complicating examination and treatment.
Swelling may extend into the cheek, submandibular region, or neck in severe cases. Dysphagia indicates spread toward the pharyngeal spaces.
Systemic features: fever (38-40°C), malaise, anorexia, and submandibular/cervical lymphadenopathy in moderate-to-severe cases.