A patient presents with severely deteriorated dental crowns; there is almost no coronal tooth structure remaining. The patient does not have a bruxism/parafunction history. Which of the following would NOT be an appropriate first step in management (i.e., which one should you AVOID doing first)?

Correct answer: A. Extraction of the teeth

• A. CORRECT (this is the answer they want you to identify as the one that should NOT be first) — Extraction is an irreversible treatment. Before any irreversible treatment, you must complete the exam, present options (including restorative alternatives such as posts, crowns, endodontic treatment), and obtain informed consent. Extractions should never be the first step.
• B. Obtaining informed consent is a required step before any treatment.
• C. A comprehensive exam is the foundation of the treatment plan and must precede any procedure.
• D. Explaining all treatment options is required and is part of informed consent.