Primary Tooth Abscess — ORE Part 1 MCQ

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EasyPaediatric DentistryPrimary Tooth AbscessORE Part 1

A cooperative 3-year-old child presents with a labial abscess associated with a traumatised maxillary primary incisor. A periapical radiograph shows periradicular radiolucency. There are no signs of systemic illness or spreading infection. What is the most appropriate management?

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Correct answer: D — Extract the affected primary incisor

The abscess and periradicular radiolucency indicate infection associated with a primary tooth. For a cooperative child, SDCEP advises extraction of a primary tooth with dental abscess/periradicular periodontitis, even if infection is asymptomatic. Extraction removes the source of infection. Pulpectomy is not routine first-line management in this setting: it is reserved for exceptional cases where the tooth is restorable and may require referral. Antibiotics alone, or antibiotics before extraction, are inappropriate for a localised dental abscess without systemic illness or spreading infection because they do not provide definitive source control. Incision and drainage without treating the infected tooth also leaves the cause in place. Therefore, extraction is the single best answer.

Reference: Scottish Dental Clinical Effectiveness Programme (SDCEP). Prevention and Management of Dental Caries in Children: Primary tooth – pain or infection, section ‘Dental abscess/periradicular periodontitis’, 2026. https://www.childcaries.sdcep.org.uk/guidance/caries-management-in-primary-teeth/primary-tooth-pain-or-infection/