If a lateral radiograph shows no periapical radiolucency (PARL), what should be done?

• A. Perform a root canal treatment
• B. Leave it alone
• C. Extract the tooth
• D. Monitor frequently

Answer: (B)

When a lateral radiograph indicates no periapical radiolucency (PARL), this suggests that there are currently no signs of infection or significant pathology associated with the tooth. In cases where the tooth appears healthy on the radiograph, a conservative approach is warranted.

Opting to leave the tooth alone is appropriate if there are no symptoms, such as pain or swelling, or evidence of pulpal necrosis or periapical disease. This approach prevents unnecessary dental procedures that may expose the tooth to additional risks and complications, especially considering that many teeth can remain asymptomatic despite prior trauma or treatment and require simply monitoring.

Monitoring frequently would not be the best course of action unless there are signs of potential issues, as doing so implies concern where none has currently arisen. Similarly, performing a root canal treatment or extracting the tooth should only be considered if there was evidence of infection or significant pathology, neither of which is present when there is no visible PARL. Therefore, the most prudent choice in this scenario is to leave the tooth alone.