Differential Diagnosis for Ulcerated Tissue on Right Lower Gums

• Single Most Likely Diagnosis
  • Periodontal Abscess: This is a localized purulent infection involving a periodontal pocket and adjacent gingiva, often presenting with ulceration, pain, and swelling. The location on the lower gums is consistent with common sites for periodontal disease.
• Other Likely Diagnoses
  • Oral Ulcer (e.g., Aphthous Ulcer): These are common, recurrent, and can appear on the gums. They are usually painful and can be triggered by trauma, stress, or certain foods.
  • Traumatic Ulcer: This could result from accidental biting of the gum, a sharp tooth edge, or dental appliances, leading to ulceration.
  • Gingivitis or Periodontitis: While not typically presenting as a distinct ulcer, severe inflammation of the gums can lead to ulceration, especially if there's significant plaque buildup or poor oral hygiene.
• Do Not Miss Diagnoses
  • Squamous Cell Carcinoma: Although less common, oral cancer can present as an ulcer that does not heal. Given the potential severity, it's crucial to consider this diagnosis, especially in patients with risk factors like smoking or tobacco use.
  • Tuberculosis: Oral TB can manifest as ulcers on the gums, tongue, or other parts of the mouth. It's essential to consider this in patients with systemic symptoms or known TB exposure.
• Rare Diagnoses
  • Eosinophilic Ulcer: A rare condition characterized by an ulcerative lesion on the oral mucosa, often associated with eosinophilia.
  • Necrotizing Ulcerative Gingivitis (NUG): A condition that leads to ulceration and necrosis of the gingival tissues between teeth, often accompanied by severe pain and halitosis.
  • Autoimmune Disorders (e.g., Pemphigus, Lupus): These can sometimes present with oral ulcers as part of their symptomatology, though they are less common causes of isolated gum ulcers.