A 7-year-old child reported to clinic with mother. The child complains of severe pain and swelling in the tooth. On examination, the child had a grossly decayed molar with abscess. What will be the next step?

As in question, child has acute symptoms of pulpitis, so treatment like pulpotomy, puipectomy or extraction should be avoided at same time. Antibiotic therapy also usually is not indicated in localized dental infection without systemic signs of an infection like fever and no facial swelling. Due to anaerobic environment of abscess and impaired leukocytic function, systemic antibiotics will be much lesser effective in restricted blood flow into the infected area. Now in abscess formation cases, to immediately relieve the pain, drainage should be done. If teeth is decayed (as mentioned in question), it can be achieved by opening of the affected tooth into the pulp chamber or if soft fluctuant mass is detected, drainage should be done through incision of the soft tissue fluctuance. After achieving drainage, patient should be observed for 1 to 3 days and proceeded further treatment according to that condition.