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Irreversible pulpitis in primary molar — ORE Part 1 MCQ

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HardPaediatric DentistryIrreversible pulpitis in primary molarORE Part 1

A 7-year-old has spontaneous night pain from a carious primary molar with recurrent buccal swelling. The tooth has more than half of the roots remaining, and the child is anxious but cooperative for examination. The dentist needs to assess furcation involvement and successor position before planning care. What is the most appropriate investigation?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: E — Periapical radiograph of the affected primary molar

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

The correct answer is E. A periapical radiograph provides the high-resolution intraoral imaging needed to assess both furcation involvement (key indicator of apical pathology extent and treatment prognosis) and successor tooth position (essential for primary molar management decisions). In a 7-year-old with irreversible pulpitis and periapical disease, periapical radiography is the appropriate targeted investigation. Panoramic radiography (A) has lower local resolution and higher radiation dose, and SDCEP guidance reserves it for pre-GA assessment. Electric pulp testing (B) does not visualise apical pathology or successor position. Sialography (C) has no role in endodontic assessment. Cephalography (D) assesses skeletal pattern, not local tooth pathology.

Reference: SDCEP: Prevention and Management of Dental Caries in Children—Radiographic assessment. https://www.childcaries.sdcep.org.uk/guidance/assessment/clinical-assessment/assessing-carious-lesions/radiographic-assessment/