Discoloured Primary Incisor — ORE Part 1 MCQ

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EasyPaediatric DentistryDiscoloured Primary IncisorORE Part 1

An 8-year-old child presents with a discoloured upper primary incisor. There is no pain, swelling or sinus tract. A periapical radiograph shows no periapical pathology and the developing permanent successor appears normal. What is the most appropriate management?

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Correct answer: C — Monitor clinically and radiographically at review visits

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

A is correct. Discolouration after trauma can reflect pulpal change, but it alone does not establish pulp necrosis or infection. This child has no symptoms or clinical signs of infection, no periapical pathology, and no apparent effect on the permanent successor. The appropriate approach is review with clinical and radiographic monitoring, intervening only if pathological signs develop. B is inappropriate because extraction is not indicated for colour change alone. C assumes non-vitality despite no supporting clinical or radiographic evidence. D is unnecessary invasive aesthetic treatment in a primary tooth. E is inappropriate: antibiotics neither prevent pulpal infection nor treat an infection that is not present. UK paediatric dental standards emphasise follow-up after dental trauma, while colour change warrants surveillance for possible later complications.

Reference: NHS England, Clinical standard: oral health and dental care for children and young people, section “Trauma” (2026), https://www.england.nhs.uk/long-read/clinical-standard-oral-health-dental-care-children-young-people/