Indig. child's lesion

[Surgicalcric]

Abcess ingrown tooth is my guess. If I am correct I would make an incision, after lido, to relieve the pressure, expose the tooth, and drain the abcess.

If not, I have no idea.

[Sacamuelas]

Correct treatment ( if any treatment is given at all).. but not the correct diagnosis/reason for treatment.

1. Lido 1:100000 epi.
2. incise "roof" off of lesion, uncovering the erupting tooth
3. Treatment complete

other option( MY FAVORITE, and in honor of a 18D I once knew named Sneaky ) is to tell mom that you will say a special Gringo chant that will heal the boy with no further complications...promise her that your spell will create a normal, healthy tooth in the place of the terrible diseased tumor currently present. Note: no treatment is an acceptable Tx. Do nothing... it will rupture on its own as the tooth continues erupting. LOL

Just so you know... it would be very uncommon for an unerupted tooth to become "abscessed". Abscess formation is almost exclusively limited to teeth that have a opening or access to the oral cavity for food/debris/bacteria to get into the area around the tooth and cause trouble.
-Sometimes, impacted teeth can form cysts around them ( almost always in adults) but they would not really be "abscessed"

Generally teeth become impacted for a reason and it almost always involves a child older than this one with a few more of the permanent teeth already erupted(causing crowding) or the retention of a bunch of primary teeth(causing crowding). In this case, it appears there is plenty of space for the tooth ( it's a 1st molar aka "six year molar") to erupt into the mouth.

In this case....
6 yr old, everything appears normal with this child, no fever ( myth always says that a child that has an erupting tooth runs a fever), no pain, no crowding, no significant swelling except in the local area, swelling is over a tooth that should be erupting normally during this time frame of his/her life, no external involvement, no partial eruption that could give access to bacteria to form trouble around the tooth.....

Anyone care to venture what this lesion is now? I bet someone on here has even had one and may not even have known it.

[Sacamuelas]

Not a bad thing to have on hand somewhere... maybe keep in a copy in your Palm. MOM's always ask questions about this...and sometimes, as in this case, it will clue you in to a diagnosis. You don't have to know the answers in your profession on this, but answer it and see how "impressed" the patients parents are with your knowledge. LOL


No answers yet on the official diagnosis of the lesion???

[Surgicalcric]

Yeah well... Impacted is what I meant...

Thank you. That made far a good learning experience.

[Sacamuelas]

edited to add- Cric I am just trying to help Bro. Your welcome.

back to thread...

Swelling, fluctuant, slight bluish coloration, no tooth in area but in location where max molar would erupt, no pain, can feel hard or pointed object underneath lesion when palpated( clue- that is the tooth that is erupting in underneath the lesion) ...

here is a differential diagnosis to help:

• eruption cyst - ***
• hematoma - no trauma hx, would typically be sore to palpation
• hemangioma- Cric killed the patient if it was this. LOL
• tooth abscess- very unlikely as I have already discussed
• amalgam tattoo- no fillings/past extraction to cause it in this Pt. Won't see this unless pt has a dental hx that includes fillings.
• pigmented nevi - google this if you want, its benign and out of the realm for an 18D's need to know, this case would not be the typical presentation due to swelling and acute/rapid onset
• malignant melanoma- Well, if it is.. the patient is terminal. VERY unlikely based on the facts of this case. Would be indurated, different coloration, etc...

Well NDD, were you on track?

[NousDefionsDoc]

Not at first, until I went back and read and looked at the picture again. And I didn't know the proper name for it.

Good case, thanks.

[Kyobanim]

While you're on the dental track . . .

You do an upper tooth extraction on a 40 year old female. When you get the tooth out you discover that the sinus was punctured while pulling the tooth.

How do you treat this in the field? (I have no idea but I thought I'd ask)

[Sacamuelas]

Originally posted by Kyobanim
While you're on the dental track . . .

You do an upper tooth extraction on a 40 year old female. When you get the tooth out you discover that the sinus was punctured while pulling the tooth.

How do you treat this in the field? (I have no idea but I thought I'd ask)

Please see the new thread I started for you, Sir... I don't want to hijack this one. I am going to post the "typical" presentation characteristics to finish this thread on " Eruption Cysts" in a bit.

[Surgicalcric]

Originally posted by Sacamuelas
... I am going to post the "typical" presentation characteristics to finish this thread on " Eruption Cysts" in a bit.

Thank you.

[Jack Moroney (RIP)]

Impacted wisdom tooth.

[Sacamuelas]

Presents very similar Sir. However, this child is to young for that particular situation.

You really know you are dealing with a dentist when he types the word "plaque" when he really meant to type the word "plague" LOL !

This teacher just couldn't let you, of all people, slide on that one, Saca.

Good thread. And please check your PM's.

Roycroft201

Sorry about the hi-jack. I just couldn't let the dentist slide about his 'plaque'. lol

Back to your regular programming.

RC201

[Sacamuelas]

You got me RC201... That is funny. Your right, it looked normal to me when I typed it. Spell checker doesn't help in that instance either. LOL

"A plaque upon your house" doesn't sound quite as scary as the intended, " A PLAGUE upon your house!" . haha

damn... got ambushed in my own back yard.

Will get to the textbook type presentation sometime today, Cric. Been a little busy this morning here at the money-maker.

back to thread...

[pulque]

Originally posted by Sacamuelas
"A plaque upon your house" doesn't sound quite as scary as the intended, "

I don't know if thats true. Plaque is yucky!

So.. why is the eruption cyst all bluish?