Periapical Abscess Definitive Treatment — ORE Part 1 MCQ

Correct answer: A — Root canal treatment or extraction of the causative tooth

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

The correct answer is A. A non-vital tooth with an acute periapical abscess and sinus tract requires source control—elimination of the causative endodontic infection. SDCEP guidance mandates drainage via endodontic access (root canal treatment) or tooth extraction. This directly addresses the causal pathology. Option B (antibiotics alone) fails because antibiotics do not eliminate the source and are adjunctive only. Option C (incision and drainage of the sinus tract) is incorrect because the sinus tract is a consequence of the periapical infection, not the primary source; drainage must be achieved through endodontic access. Options D and E are unsafe—mouthwashes and observation delay essential treatment and risk systemic spread (osteomyelitis, cellulitis). The difficulty is Easy because recognition of source control as the principle governing acute abscess management is fundamental to endodontic practice.

Reference: SDCEP Acute Apical Abscess management, MADP, https://madp.sdcep.org.uk/content/conditions-library/acute_apical_abscess.html