Literally means inflammation (-itis) of the gum around (peri) the crown of a tooth.

Pathology
The partially erupted third molar tooth is partially covered by loose unattached gingiva. Operculum is the flap of loose gum around the tooth. This is a haven from the toothbrush, and hence plaque accumulates around the gingiva and food impaction into the loose gum occurs. This causes a localised inflammation and infection.

Signs and Symptoms
Young adult, late teens/early twenties.
Toothache.
Soreness to touch; sometimes related to eating, but not to holt/cold drinks.
The gingiva inflamed and only part of the tooth is visible.
Submandibular lymphadenopathy is present.
Occasionally the infection is severe enough to cause trismus, facial swelling and malaise.
Also referred pain e.g. ear aches.

Microbiology
Mixed aerobic and anaerobic bacteria.

Treatment
Local irrigation of the area with an antiseptic like chlorhexidiene using a Monojet syringe.
Antibiotics may be prescribed e.g Amoxicillin 500 mg tid 20. Metronidazole 400 mg tds 20.
If it is a lower molar, consider removing the opposing upper wisdom tooth that might be traumatising the lower operculum.
Remove the tooth only after the acute infection has subsided. If the tooth will erupt into the oral cavity fully in a good position, then removal of the tooth may not be necessary. It is only necessary if the tooth is impacted i.e. cannot erupt further, and is the same factors are present again for the pericoronitis to recur.

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