Case for Week #7

A 26 year old male presents to the local emergency room with a constant sharp pain radiating from the mandibular left second molar up to the left temporal region. The pain has been present off and on for 2 weeks but is now constant and severe. He begs to have the tooth extracted. Intra-oral exam reveals a severly decayed mandibular left second molar. There is some tenderness to extra-oral palpation and intra-oral plapation. There is a very slight degree of swelling in the buccal vestibule adjacent to this tooth. There is no limit to mandibular opening and a radiograph reveals no periapical pathology. The correct treatment is:

1. Administer an inferior alveolar nerve block and place a drain in the buccal swelling.
2. Administer an inferior alveolar nerve block and extract the second molar.
3. Administer an inferior alveolar nerve block and estabish drainage through the tooth (Root Canal).
4. Place the patient on oral antibiotics and reevaulate in 24 hours. Advise the patient to return earlier if the swelling increases or if there is any diificulty breathing or swallowing.