PERICORONITIS

Inflammation of the operculum covering an erupting tooth occurs more commonly in association with the mandibular wisdom teeth.

Causes

  • Usually associated with partially erupted and/or impacted third molars
  • Associated trauma from a tooth in the opposing arch is usually present

Clinical features

  • Pain, trismus, swelling
  • Halitosis
  • The operculum is swollen, red, and often ulcerated
  • Fever and regional lymphadenitis may be present

MANAGEMENT

Surgery

  • Operculectomy done under local anaesthesia
  • Extraction of the third molar associated with the condition
  • Grinding or extraction of the opposing tooth
  • Apply caustic agents (trichloracetic acid and glycerine)

Treat with analgesic and antibiotic for 5-7 days

  • Paracetamol 500 mg every 8 hours
    Child: 10-15 mg/kg every 8 hours

    • Or ibuprofen 400 mg every 8 hours
      Child: 7-13 mg/kg every 8 hours
    • Or diclofenac 50 mg every 8 hours
  • Amoxicillin 500 mg every 8 hours
    Child: 25 mg/kg every 8 hours

    • Add metronidazole 400 mg every 8 hours if necessary
      Child:10-12.5 mg/kg per dose