Primary Incisor Enamel Fracture — ORE Part 1 MCQ

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EasyPaediatric DentistryPrimary Incisor Enamel FractureORE Part 1

A child attends after a fall. A primary maxillary incisor has a small enamel-only chip (<5 mm). The tooth is firm, undisplaced and asymptomatic, with no dentine or pulp exposure. What is the most appropriate management?

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Correct answer: A — Smooth sharp edges and review the tooth

This is an uncomplicated enamel-only crown fracture in a primary incisor: the tooth is firm and undisplaced, and there is no dentine or pulp exposure. The appropriate care is conservative—remove or smooth any sharp enamel edge, give appropriate trauma advice and arrange review. NHS England includes smoothing sharp edges within Level 1 management of uncomplicated crown fractures, while SDCEP identifies pulp therapy only where the pulp is involved and extraction only for a non-restorable tooth. Composite restoration may be appropriate if aesthetics or a larger defect warrants it, but is unnecessary for this small uncomplicated chip. Pulpotomy is not indicated without pulpal involvement. Extraction and a preformed metal crown are disproportionate; preformed metal crowns are not appropriate for a minor fracture of a primary incisor.

Reference: NHS England. Clinical standard: oral health and dental care for children and young people, Dental trauma management section, updated 22 June 2026. https://www.england.nhs.uk/long-read/clinical-standard-oral-health-dental-care-children-young-people/