Pregnant adolescent attending with her parents

Correct answer: A. Complete the cleaning and encourage her to tell her parents herself

• A. Best general answer. Provide the indicated care, preserve the confidence, and counsel her toward disclosure with support. Adolescent confidentiality around reproductive health is protected in most jurisdictions, and pregnancy itself may confer emancipated or specially protected status. Coercive disclosure destroys trust and may deter her from seeking prenatal care.
• B. Delegating the disclosure to staff is the same breach, with the added failure of not owning the decision.
• C. Withholding a routine, safe and beneficial cleaning as leverage is coercive and unethical.
• D. Unilateral disclosure risks breaching confidentiality and may be unlawful depending on the jurisdiction.

Note: ⚠️ Genuinely jurisdiction-dependent. State law governs adolescent confidentiality, emancipation and the treatment of reproductive health information. The examinable principle is: maintain confidentiality and encourage voluntary disclosure.

Correct answer: B. Necessary dental treatment should be provided, with the second trimester generally most comfortable

• A. Deferring necessary treatment, particularly of infection, actively harms both patient and pregnancy.
• B. CORRECT. Necessary care should not be withheld. Untreated infection poses a far greater risk to mother and fetus than treatment does. Elective care is often scheduled in the second trimester, when organogenesis is complete and the patient can lie comfortably; in the third trimester, avoid the supine position to prevent supine hypotensive syndrome.
• C. Radiographs may be taken when diagnostically necessary, with a lead apron and thyroid collar. Fetal dose from dental radiography is negligible.
• D. Lidocaine with epinephrine is category B and is safe in the doses used in dentistry. Good anaesthesia reduces maternal stress.