Endodontics · patient case question
What is the appropriate treatment for this tooth?
Patient case: Swelling and pain on a lower first molar
Patient: 32-year-old patient, emergency visit.
Chief complaint: Throbbing pain and a swelling on the lower right.
History: Two days of increasing pain, now spontaneous and keeping him awake. No systemic upset.
Findings: Gross carious lesion on tooth 30 with a periapical radiolucency. The tooth is tender to percussion and does not respond to cold testing. Localized vestibular swelling. The tooth is restorable with adequate remaining structure and normal periodontal support.
Show answer and explanation
Correct answer: A. Root canal treatment
- A. CORRECT. A necrotic pulp with an acute apical abscess in a RESTORABLE tooth with sound periodontal support is treated endodontically. Access and canal debridement drains the source and relieves pain; the definitive restoration follows.
- B. Extraction is for a non-restorable tooth. This one is described as restorable with good support.
- C. Pulp capping requires a vital pulp. This tooth is necrotic — it does not respond to cold and has a periapical lesion.
- D. Antibiotics do not reach a necrotic canal, which has no blood supply. Without mechanical debridement they merely delay definitive care.