A periapical abscess is present on a lower right mandibular first molar that has extensive caries. The tooth is restorable. What is the appropriate treatment?

Correct answer: D. Root canal treatment

• A. Scaling and root planing treats PERIODONTAL disease, not a pulpal/periapical abscess.
• B. Fluoride prevents caries but does nothing for an established periapical infection.
• C. Doing nothing allows the infection to progress (cellulitis, spread, bone loss).
• D. Correct. A periapical abscess of a restorable tooth arises from an infected/necrotic pulp, so root canal treatment (with drainage of infection) is the definitive tooth-preserving treatment. (Extraction is the alternative if non-restorable.)