Infected Primary Incisor — ORE Part 1 MCQ

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ModeratePaediatric DentistryInfected Primary IncisorORE Part 1

A 7-year-old child attends following trauma to an upper primary incisor. The tooth is non-vital. A periapical radiograph shows a periapical radiolucency overlying the developing permanent incisor, which appears undisplaced and morphologically normal. What is the most appropriate management?

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Reveal the answer and explanation

Correct answer: D — Extract the primary incisor and review the permanent successor

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

A is correct. The non-vital primary incisor and periapical radiolucency indicate established infection. SDCEP advises definitive management of an infected primary tooth by extraction or, in selected circumstances, pulpectomy; infection should not be left untreated. In this traumatised, infected primary incisor, extraction removes the focus of infection and avoids ongoing risk to the closely related developing permanent successor. C is a possible specialist alternative only in selected cases, but is not the best routine answer here. B is inappropriate because a radiolucency is evidence of infection, not a finding for observation alone. D may be needed only for systemic spread or as an adjunct where indicated, but antibiotics alone do not eradicate the dental source. E is unnecessary: loss of a primary incisor does not normally require space maintenance.

Reference: Scottish Dental Clinical Effectiveness Programme (SDCEP). Prevention and Management of Dental Caries in Children: Caries management in primary teeth, current web guidance (checked July 2026). https://www.childcaries.sdcep.org.uk/guidance/caries-management-in-primary-teeth/