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Dr. Katz
Dr. Katz, Dentist - DDS
Category: Dental
Satisfied Customers: 3565
Experience:  Dentist and Anesthesiologist for 37 years.Anesthesiology Fellow-Johns Hopkins School of Medicine.Evaluator for Maryland State Board of Dental Examiners.
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Our pediatric dentist spotted what he called a parulis

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Our pediatric dentist spotted what he called a parulis lesion on my 21 month old child's gum near the bottom left molar. It doesn't appear to hurt. Can such a lesion be caused by trauma, or is it always due to an infection? Also, will it go away on its own, or will it need to be treated? How is it treated?
Welcome .I will do my best to answer your question.I am not a great typist,be patient and feel free to ask if anything is unclear.A parulis is just a fistula or a drainage tract from an abcess.In the mouth it is most likely coming from a tooth.Trauma to a tooth can cause and abcess as well as a fracture or decay.Decay is the most common cause of dental infections.At 21 months old,it is not particularly common to see these abcesses unless there is rampant decay associated with it.Does your child have other decayed teeth ? A parulis ,because it is just a tract of infection,has a source and the source needs to be treated before it will go away.It will not go away on its own.It may get smaller sometimes because it will burst and release the pus from the adjoining sac,however it will fill up again.The way this is treated in this agegroup is most commonly extraction of the infected tooth.
Customer: replied 4 years ago.

As far as I know, the tooth is healthy. No sign of decay. The "parulis" looks like a pimple on her gum. I could it be something else?

Without seeing an xray of the area,it would be difficult to tell where the fistulous tract is coming from but it is most likely from a tooth.The pimple on the gum is really what a parulis looks like.Is it puffy at all or does it appear to be draining.Is the tooth loose at all? Are there any other areas of decay or are all of the teeth healthy?
Customer: replied 4 years ago.

There is no sign of decay on any of her teeth, including where the parulis is. It is red and puffy, but there is no drainage. Our dentist could not express anything either. He wanted to wait and see if it went away within 2 weeks, but it is still there after a week and a half, unchanged.

Also, her tooth is not loose.

If the tooth is free from decay,there could be a possibility that something may be caught under the gum causing infection or the tooth itself may be fractured.It is not common to have a parulis without an infected tooth in the mouth.
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I will check back with you to see what the dentist has concluded.