A pregnant patient in her THIRD TRIMESTER has cold sensitivity AND tenderness to percussion on tooth #19 (no abscess visible on X-ray). What is the MOST appropriate treatment?

Correct answer: C. Perform root canal treatment (pulpectomy) now

• A. Incorrect. Waiting with active irreversible pulpitis + apical periodontitis until delivery is NOT appropriate. Dental infections during pregnancy may carry risks for both mother and fetus.
• B. Incorrect. Extraction is a more traumatic alternative. Endodontic treatment to save the tooth is preferred.
• C. Correct. Root canal treatment (pulpectomy) should be performed now. Necessary dental treatment including endodontics is SAFE throughout pregnancy with appropriate precautions (left-lateral positioning in third trimester, lead apron, safe local anesthetics). Removing the infected pulp eliminates infection and pain.
• D. Incorrect. Analgesics alone do not address the underlying infection — ongoing pulpal infection during pregnancy poses a risk.