Ethics & Law · patient case question
A parulis on the buccal vestibule adjacent to tooth #9 represents:
Patient case: Ethics and Occupational Exposure
demo: Multiple scenarios in one practice day
chief: Ethical and occupational issues arising during clinic
history: Scenario 1: a patient in pain demands extraction of two restorable teeth; the dentist believes root canal therapy is the better option. Scenario 2: a different patient with a periapical lesion refuses the recommended extraction. Scenario 3: an HIV-positive patient presents with a parulis on the buccal gingiva of #29. Scenario 4: the dentist sustains a needlestick from a used anesthetic needle.
meds: Not applicable
findings: See individual scenarios.
Show answer and explanation
Correct answer: A. The intraoral opening of a sinus tract draining a chronic infection
- A. Correct. A parulis — gum boil — is the soft tissue opening of a sinus tract from a necrotic pulp or a periodontal abscess. Tracing it with a gutta-percha point on a radiograph identifies the source tooth.
- B. A fibroma is a firm, pale, sessile nodule at a site of chronic irritation with no drainage.
- C. A mucocele is a fluctuant, bluish, mucin-filled swelling most common on the lower lip.
- D. A pyogenic granuloma is a vascular proliferation, red and friable, that bleeds readily and is not a drainage point.