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Dental Phobia Treatment Planning — ORE Part 1 MCQ

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ModerateDental Public Health & EpidemiologyDental Phobia Treatment PlanningORE Part 1

A 40-year-old patient with severe dental phobia has avoided dental care for 10 years. They have multiple carious teeth and a localised fluctuant intraoral swelling associated with a carious tooth. They are otherwise well, with no facial swelling, fever or dysphagia. Which treatment-planning approach is most appropriate?

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Correct answer: B — Assess fully, control the acute problem locally, then provide staged care with anxiety support

**A is correct.** Management should begin with a full assessment and control of the acute source of infection, using local measures such as drainage through the tooth or incision and drainage where appropriate, with analgesia. In a patient without systemic or spreading infection, antibiotics are not routine. Once urgent symptoms are controlled, definitive treatment should be planned in stages, adapting appointment length and using behavioural anxiety management; sedation or specialist referral may be considered where indicated. **B** is disproportionate: general anaesthesia and clearance are not a default response to phobia. **C** wrongly withholds needed care. **D** is inappropriate because prolonged pre-assessment antibiotics neither replace diagnosis nor local treatment. **E** disregards the need for assessment, acute stabilisation and a graded approach for severe phobia.

Reference: Scottish Dental Clinical Effectiveness Programme (SDCEP). Management of Acute Dental Problems, 2nd edition: “Acute apical abscess”, March 2026. https://www.acutedentalproblems.sdcep.org.uk/guidance/management-of-oral-conditions/common-oral-conditions/acute-apical-abscess/