Pediatric Dentistry · patient case question
What is the treatment?
Patient case: 5-year-old — bump on tooth F after trauma
Scenario: A 5-year-old fell and lost tooth E last month. She now has a bump on tooth F that appeared 3 days ago. The tooth is DARKER than the adjacent teeth and has some mobility. Radiographs show LESS THAN 1/3 of the root remaining.
Show answer and explanation
Correct answer: A. Extraction of the primary tooth
- A. Correct. With LESS THAN ONE THIRD of the root remaining, the tooth is close to exfoliation and has inadequate root structure to support pulp therapy. A necrotic primary tooth with an active sinus tract and advanced resorption is extracted to protect the developing permanent successor.
- B. Incision and drainage manages an acute swelling but leaves the source of infection — the necrotic pulp — in place.
- C. Antibiotics do not address the necrotic pulp and are not indicated for a localised, drainable odontogenic infection in a healthy child.
- D. Pulpectomy requires adequate remaining root length and a restorable tooth; with under 1/3 of root left, obturation is not feasible and would risk damaging the permanent tooth germ.
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