Dental abscess: The Daily PANCE Blueprint

Dental abscess: The Daily PANCE Blueprint

A 34-year-old female presents with localized gum swelling and throbbing pain around a decayed upper premolar. Exam shows a fluctuant, tender area with erythema but no fever, trismus, or lymphadenopathy. Which of the following best describes the underlying cause of her condition?

A. Viral infection leading to necrosis of the periodontal ligament
B. Autoimmune destruction of dental pulp tissue
C. Hematogenous spread of bacteria from a distant infection
D. Fungal invasion of the gingiva leading to abscess formation
E. Bacterial overgrowth following tooth decay, causing pus accumulation in the pulp

Answer and topic summary

The answer is E. Bacterial overgrowth following tooth decay, causing pus accumulation in the pulp

A dental abscess is defined as an accumulation of purulent fluid in the periodontal tissue or dental pulp. The most common type is a periodical abscess. Due to tooth decay or trauma, bacteria start to overgrow and infect the pulp of the tooth, leading to a collection of pus. Clinical features include swelling/erythema, purulent discharge, tooth pain, etc. Red flags of a severe/spreading infection include trismus, lymphadenopathy, headache, neck pain, swelling of the face/neck, and fevers. CT head/neck should be obtained if these red flags are present. An oral surgeon or dentist should consult for I&D of the abscess. IV antibiotics should be started (e.g., Augmentin, penicillin, etc).

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Smarty PANCE Content Blueprint Review:

Covered under ⇒ PANCE Blueprint EENT⇒ Oropharyngeal disorders (PEARLS) ⇒ Diseases of the teeth and gums

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