Differential Diagnosis for White Head with Induration in the Gum Above Tooth

• Single Most Likely Diagnosis
  • Periodontal abscess: This condition is characterized by a localized purulent infection within the tissues supporting the teeth, often presenting with a white head (purulent discharge) and induration (hardening of tissue) in the gum. The proximity to a tooth and the symptoms described make this a highly plausible diagnosis.
• Other Likely Diagnoses
  • Periapical cyst or granuloma: These are lesions that form at the tip of a tooth root, often as a result of pulp necrosis. While they might not always present with a visible white head, they can cause localized induration and could potentially lead to the formation of a sinus tract that might appear as a white head.
  • Gingival cyst: A gingival cyst is a type of odontogenic cyst that can occur on the gum and might present with a white head, although it's less common for them to cause significant induration.
• Do Not Miss Diagnoses
  • Squamous cell carcinoma: Although less likely, oral cancers can present in various forms, including as a white lesion with induration. Given the potential severity of this diagnosis, it's crucial not to miss it, even if the presentation seems atypical.
  • Lymphoma or other malignancies: Rarely, lymphomas or other malignancies can manifest in the oral cavity, including the gums, with a variety of symptoms that might initially seem benign.
• Rare Diagnoses
  • Odontogenic keratocyst: Now more commonly referred to as keratocystic odontogenic tumor, this is a type of cyst that can occur in the jaw and, very rarely, might present with a visible component in the gum.
  • Stafne bone cavity: This is a rare, benign condition where a cavity forms below the inferior alveolar nerve, usually in the mandible. While it doesn't typically present with a white head or gum induration, it's an unusual condition that could potentially cause confusion in diagnosis if it were to present atypically.