Question

In a 4 year old the most appropriate treatment for a

chronically infected, non-restorable primary first
molar is to
A. extract it and place a space maintainer.
B. observe it until it exfoliates.
C. extract it only.
D. observe it until it becomes symptomatic.

Answer 1

The most appropriate treatment for a 4-year-old's chronically infected non-restorable primary first molar is extraction and placement of a space maintainer to prevent further complications and ensure proper spacing for permanent teeth.

Step-by-step explanation:

In the case of a chronically infected, non-restorable primary first molar in a 4-year-old child, the most appropriate treatment is to extract the tooth and place a space maintainer. This is critical because retaining the infected tooth can lead to further health complications, such as the potential spread of infection and painful abscesses. Moreover, primary teeth are placeholders for the permanent teeth, and their premature loss without placing a space maintainer can lead to space loss and future orthodontic problems due to shifting teeth.

Microbes, particularly the most important cariogenic species of bacteria, which is Streptococcus mutans, contribute to tooth decay by metabolizing sugars and producing acids that erode dental enamel, leading to cavities. If the decay reaches the pulp of the tooth, it may necessitate a root canal or extraction to remove the infected tissues and prevent the infection from spreading, which could result in more serious dental conditions and systemic infections.