Neutropenic Dental Abscess — ORE Part 1 MCQ

Correct answer: D — Arrange urgent drainage, prescribe systemic antibiotics, and liaise promptly with the oncology/haematology team

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

**A is correct.** In an immunocompetent patient with a localised dental abscess and no systemic spread, drainage/source control is first-line and antibiotics are not routinely indicated. However, SDCEP states that antibiotics are appropriate for oral infection in an immunocompromised patient and that such patients have a lower prescribing threshold because of their increased risk of complications, including sepsis. Severe chemotherapy-induced neutropenia is therefore a major management modifier: arrange urgent definitive drainage where clinically feasible, prescribe systemic antibiotics, and promptly liaise with the oncology/haematology team. NHS SPS also advises vigilance for neutropenic sepsis in chemotherapy patients with dental infection. B applies the usual immunocompetent approach; C, D and E dangerously leave an infection without adequate systemic treatment and source control.

Reference: Scottish Dental Clinical Effectiveness Programme (SDCEP), Management of Acute Dental Problems, 2nd edition, “Management of spreading or systemic infection”, March 2026: https://www.acutedentalproblems.sdcep.org.uk/guidance/overarching-principles/management-of-spreading-or-systemic-infection/