Which symptom is commonly associated with a periapical abscess?

• A. Severe, throbbing pain, chronic less severe.
• B. Immediate relief with hot drinks.
• C. Sensitivity to cold only and not heat.
• D. No pain even with palpation.

Answer: (A)

The main idea here is that a periapical abscess typically causes a severe, throbbing toothache due to pressure from pus accumulating at the tooth root and the surrounding inflammatory response. This pain is often persistent and can be intense, sometimes worsening with lying down or with touch or chewing. Swelling of the adjacent tissues may accompany the pain, and the tooth tender to percussion is common.

Immediate relief with hot drinks doesn’t fit the pattern, because heat tends to worsen inflammatory pain rather than relieve it. Sensitivity to cold only isn’t the characteristic presentation either; thermal responses can vary, but an abscess pain is not typically limited to cold. No pain on palpation would also be inconsistent with an abscess, which usually presents with tenderness and sometimes visible swelling.