During a routine examination, a patient presents with a painful gum area. What is the first step in the treatment plan?

In a scenario where a patient presents with a painful area in the gums, the initial step in the treatment plan typically involves addressing the underlying cause of the discomfort. Performing scaling and root planing is appropriate as it directly targets the potential causes of gum pain, usually associated with periodontal disease. This procedure helps remove plaque and tartar buildup below the gum line, which can be contributing to inflammation and pain.

By performing scaling and root planing, not only can the dental professional alleviate the current pain through the removal of irritants, but they can also initiate healing of the periodontal tissues. This corrective action often leads to an improvement in symptoms and can help prevent further complications.

Other options, while they might be relevant to the situation, do not address the problem directly. Prescribing analgesics could help with pain but does not resolve the underlying cause. Referring for a second opinion could be unnecessary at this stage and does not address the immediate issue. Immediate extraction might be considered only in cases of severe pathology or other specific circumstances, making it an extreme first step rather than a foundational treatment plan.