Which factor should most influence the decision…
Pharmacology questions in the ADC written exam test applied prescribing decisions, not rote recall of drug names. This exam-level vignette tests your ability to work through clinical details and arrive at the correct management.
A 17-year-old male has a grossly carious nonvital mandibular right first molar with a periapical abscess. The caries is extensive and restoration will be complex and expensive. The tooth has drifted mesially, losing its contact with the second premolar. The patient says he doesn't mind having a gap if extraction is simpler. Which factor should most influence the decision between extraction and endodontic treatment?
- A. The patient's preference for extraction, which should be respected
- B. The condition and long-term prognosis of the other molar teeth
- C. The cost and complexity of endodontic treatment compared to extraction
- D. The fact that the missing tooth would not be readily visible
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If other molars are also compromised and likely to be lost in the short or medium term, it makes sense to conserve whichever teeth can be successfully restored — losing multiple molars has far greater functional consequences than losing one. The decision depends on the broader prognosis of the dentition, not just this single tooth.
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