A pregnant patient in the third trimester has pain on tooth #19 with lingering pain to cold and tenderness to percussion. What is the appropriate treatment?

Correct answer: C. Pulpectomy (complete pulp removal)

• A. Incorrect. Pulpotomy is an interim measure in permanent teeth and leaves inflamed radicular pulp, risking recurrence.
• B. Incorrect. General anesthesia carries substantially higher risk and is unnecessary; the tooth is restorable.
• C. Correct. Lingering cold pain indicates irreversible pulpitis, and percussion tenderness indicates apical involvement. Complete removal of the pulp resolves the pain definitively and is safe in pregnancy with appropriate precautions.
• D. Incorrect. Leaving an infected tooth for weeks risks abscess formation and systemic spread — a far greater fetal risk than treatment.