Impacted Third Molar — ORE Part 1 MCQ
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Correct answer: C — Recurrent pericoronitis (two or more episodes)
Explanation lettering: D = shown as A · C = shown as B · A = shown as C · E = shown as D · B = shown as E
NICE TA1 guidance restricts third molar removal to cases with evidence of pathology. Regarding pericoronitis specifically, the evidence shows a first episode (unless particularly severe) should not trigger surgery, but second or subsequent episodes (recurrent pericoronitis) are appropriate indications. Option A describes recurrent infection managed with antibiotics, meeting the threshold for surgical intervention. Options B and E are explicitly rejected by NICE (no evidence supports prophylactic removal of asymptomatic teeth). Option C: plaque formation and mild food impaction are risk factors but not themselves indications. Option D: cosmetic request alone is not pathological justification. This question tests understanding of the NICE distinction between first and recurrent pericoronitis—a key discriminator in third molar decision-making at Moderate difficulty.
Reference: NICE Technology Appraisal 1. Guidance on the extraction of wisdom teeth. Recommendations section. https://www.nice.org.uk/guidance/ta1/chapter/1-Recommendations