Pregnancy Dental Treatment — ORE Part 1 MCQ

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ModerateOral SurgeryPregnancy Dental TreatmentORE Part 1

A 30-year-old woman in the second trimester of pregnancy has a clinically typical gingival pregnancy epulis. Despite plaque-control measures, it causes substantial discomfort and prevents normal eating. What is the most appropriate management?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: C — Excise the lesion under local anaesthesia during the second trimester

Explanation lettering: B = shown as A · C = shown as B · A = shown as C · E = shown as D · D = shown as E

A is correct. Pregnancy epulis often regresses after delivery, so uncomplicated lesions are normally managed with plaque control, reassurance and review. In this case, however, the lesion continues to prevent normal eating despite conservative measures. Significant functional impairment justifies removal during pregnancy. The second trimester is the preferred period for necessary non-urgent dental treatment, and excision under local anaesthesia avoids the additional risks of general anaesthesia. B would be appropriate for a lesion without important symptoms, but not where eating is impaired. Corticosteroids have no established role in this reactive lesion. General anaesthesia is unnecessary when local excision is feasible. Silver nitrate is not definitive management and would not provide tissue for histopathological assessment.

Reference: Royal Devon University Healthcare NHS Foundation Trust. Oral health and pregnancy: frequently asked questions. Pregnancy epulis section. https://www.royaldevon.nhs.uk/media/eerc4kgi/oral-health-and-pregnanacy-frequently-asked-questions.pdf