Endodontics · patient case question
What is the most appropriate treatment for tooth #19?
Patient case: Endodontic Emergency in Pregnancy
demo: 29-year-old female, 32 weeks pregnant
chief: “The lower left tooth has been keeping me awake for three nights.”
history: Uncomplicated pregnancy, third trimester. Obstetrician cleared for necessary dental care.
meds: Prenatal vitamins
findings: Tooth #19 with a deep distal carious lesion, lingering pain to cold, tender to percussion. Vital pulp on access.
Show answer and explanation
Correct answer: A. Pulpotomy to relieve the acute symptoms
- A. Correct. Removing the inflamed coronal pulp relieves the pain immediately, is a short appointment well tolerated in the third trimester, and allows definitive treatment later.
- B. Leaving an acutely inflamed pulp untreated with opioids risks progression to abscess and exposes the fetus to unnecessary medication.
- C. A sedative dressing will not control pain from irreversible pulpitis.
- D. Extraction sacrifices a restorable tooth and is more invasive than needed.