A patient reports sensitivity in the lower right area and feels that tooth #30 is hitting hard on the opposing tooth. The tooth is tender to percussion. Which of the following would be the LEAST LIKELY cause of sensitivity of tooth #30?

Correct answer: A. Apical pathology

• A. CORRECT (EXCEPTION). Apical pathology (periapical abscess or chronic periapical periodontitis) would typically cause sensitivity to biting and percussion, but the clinical presentation here — hyperocclusion on a specific tooth with sensitivity to tapping — is more consistent with occlusal trauma or hypersensitivity. Apical pathology is the LEAST LIKELY cause in the context described, where the tooth is hitting hard and super-erupting, pointing to occlusal causes first.
• B. Super-eruption of tooth #30 (due to loss of opposing tooth or occlusal imbalance) can cause premature contact, sensitivity, and percussion tenderness — making this a plausible cause.
• C. Recession exposes the root dentin, which is sensitive to various stimuli. This is a plausible cause of sensitivity, especially in combination with occlusal trauma.
• D. Bruxism can cause occlusal trauma, leading to sensitivity, tenderness to percussion, and the feeling that a tooth is hitting hard. Bruxism is a likely contributing factor to this presentation.