A patient who uses amphetamines presents with swelling in the lower left region, blood pressure of 138/90, fever of 101°F, and dry mouth. What is the most appropriate next step?

Correct answer: D. Refer to a physician

• A. Proceeding with a dental procedure in a febrile patient (101°F) with signs of systemic infection and active amphetamine use is contraindicated. The patient is medically unstable.
• B. Incision and drainage may eventually be needed, but this patient has systemic signs of infection (fever, swelling) combined with amphetamine use, elevated blood pressure, and dry mouth. Proceeding with a surgical procedure without medical consultation and stabilization puts the patient at risk.
• C. Finalizing a treatment plan and rescheduling is inappropriate when the patient has active infection with systemic signs (fever, elevated BP, swelling) — this constitutes a medical urgency requiring prompt referral.
• D. CORRECT. This patient presents with systemic signs of infection (fever 101°F, swelling) combined with active amphetamine use, elevated blood pressure (138/90), and xerostomia. The combination of these findings — especially fever, known drug use affecting cardiac and systemic function, and elevated BP — makes medical referral the priority. A physician must evaluate and stabilize the patient before any dental treatment is performed.