A Painless Nodule on the Gingiva of a 14-Year-Old Girl

Authors:
David Joy, MD
Division of Adolescent Medicine, Department of Pediatrics, University of Florida, Gainesville, Florida

Kiran Upadhyay, MD
Department of Pediatrics, University of Florida, Gainesville, Florida

Ratna Acharya, MD
Division of Adolescent Medicine, Department of Pediatrics, University of Florida, Gainesville, Florida

Citation:
Joy D, Upadhyay K, Acharya R. A painless nodule on the gingiva of a 14-year-old girl. Consultant. 2019;59(11):327-328.

A 14-year-old girl presented to the clinic for preoperative clearance for a dental procedure.

History. The girl had had an ongoing problem with dental crowding in the area of the upper central incisors, and a previous computed tomography scan of the head had identified a cyst emanating from the area of the dental crowding and extending into and obliterating the maxillary sinuses. The patient stated that she had come to the clinic in order to be cleared for a dental procedure for which she had waited a long time.

Physical examination. She denied dental pain, oral ulcers, oral edema, oral erythema, fever, chills, nausea, and headache. Her vital signs were within normal limits for her age, and she was in no acute distress. On physical examination, she smiled to show her teeth and to allow examination of the area of deformity. There was mild erythema of the gums in the area with no tenderness. On further examination using a tongue depressor to raise the upper lip and visualize the entire gingiva, a soft, whitish pustule was noted just above the maxillary central incisor (Figure).

Figure. A soft, whitish pustule just above the maxillary central incisor.