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Pericoronitis Operculum Trauma — ORE Part 1 MCQ

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ModerateOral SurgeryPericoronitis Operculum TraumaORE Part 1

An adult has a first, non-severe episode of pericoronitis around a partially erupted lower third molar. The inflamed operculum is traumatised by the opposing upper third molar, which is unlikely to achieve useful occlusion. There is no facial swelling, trismus, systemic illness or immunocompromise. What is the most appropriate management?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: B — Adjust or extract the opposing upper tooth and provide local pericoronitis care

Explanation lettering: D = shown as A · A = shown as B · B = shown as C · E = shown as D · C = shown as E

A is correct. The discriminating feature is repeated trauma to the inflamed operculum from an upper third molar that has no likely future function. SDCEP advises adjusting or extracting an opposing tooth in this situation, with local measures such as irrigation/debridement, oral-hygiene advice and analgesia. Lower-third-molar extraction is not the most appropriate immediate choice for a first non-severe episode; NICE states that a first episode of pericoronitis is not usually an indication for surgical removal. Antibiotics are not indicated without spreading infection, systemic features or relevant immunocompromise. Operculectomy may be considered after acute inflammation settles in selected cases, but it does not address the specified traumatic cause. Treating only the lower tooth leaves the operculum subject to continued trauma.

Reference: Scottish Dental Clinical Effectiveness Programme. Management of Acute Dental Problems: Acute pericoronitis (including erupting teeth in children), subsequent care section, 2026. https://www.acutedentalproblems.sdcep.org.uk/guidance/management-of-oral-conditions/common-oral-conditions/acute-pericoronitis-including-erupting-teeth-in-children/