The Case of a Gum Boil

A 46-year-old female came to the dental clinic for routine dental care. Her teeth were in a pretty bad state. She also complained about a "pimple" in her mouth that gets bigger with time, bursts and then gets bigger again. 

Intra-oral examination revealed a 3 x 3 mm papules above the right maxillary lateral incisor. The lateral incisor was extensively carious. A radiograph was taken to confirm presence of periapical inflammatory disease at the site. A prominent radiolucency was noted above the tooth. 

46-year-old female with a parulis

The diagnosis of parulis was made. The patient preferred to undergo extraction for the lateral incisor.  Histopathology of the tissue acquired during the extraction confirmed periapical inflammatory disease. The lesion had healed by the time the patient returned for her denture appointment. 

Parulis:

Parulis, also known as gum boil is a sinus tract that opens into the oral cavity. The sinus tract originates the apex of the infected tooth, passes through the bone and opens at an intra-oral site. It is usually reddish-yellow in color. Although gingiva is the most common site of involvement, other sites like the palate, the buccal and lingual vestibules may also be involved. The increase in size is due to the accumulation of pus inside the lesion. Once the pus is released, the lesion returns to its original size. Radiographs are useful in establishing diagnosis. The affected tooth is either extracted or root canal treated.