Oral Surgery · single question
Which of the following is an indication for systemic antibiotics in a dental infection?
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Correct answer: C. Temperature of 101°F
Antibiotics are indicated for dental infections with SYSTEMIC SPREAD signs: fever (temperature ≥100.4°F / ≥38°C), lymphadenopathy (enlarged/tender lymph nodes), cellulitis, trismus, or malaise indicating spread beyond the local site. A temperature of 101°F indicates the body's systemic inflammatory response to infection — this is a definitive indication for antibiotics. Nocturnal pain and radiating pain are features of pulpitis/periapical pathology (treat the source, not antibiotics). 5mm lymph nodes are typically within normal variation.
- A. INCORRECT. Nocturnal pain is a feature of irreversible pulpitis — it indicates pulpal pathology, not spreading infection. The treatment is pulp therapy (RCT or extraction), not antibiotics.
- B. INCORRECT. 5mm lymph nodes are generally within normal size variation. Lymphadenopathy is typically considered significant when lymph nodes exceed 1-2 cm or become tender/indurated — 5mm alone is not an antibiotic indication.
- C. CORRECT. FEVER (temperature ≥100.4°F/38°C) is a classic systemic sign of spreading infection, indicating the immune system's pyrogenic response. A temperature of 101°F is a clear indication for antibiotics in conjunction with surgical drainage/source elimination.
- D. INCORRECT. Radiating pain can indicate severe pulpitis or spreading infection but alone is not an indication for antibiotics — source control is primary.