Pericoronitis

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

Cause

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

Clinical features

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

Management

Treatment LOC

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
 HC4