Differential Diagnosis for Painful Lump on Upper Gum Area
- Single most likely diagnosis
- Traumatic tooth injury or pulpitis: The patient's history of a puppy head-butting her in the face, followed by the development of a painful lump on the upper gum area and pain shooting down into the descending tooth when touched, suggests a traumatic injury to the tooth or surrounding tissues. This could lead to pulpitis, an inflammation of the dental pulp.
- Other Likely diagnoses
- Dental abscess: An infection of the tooth or surrounding tissues could cause a painful lump and radiating pain, especially if the tooth is non-vital or has a deep cavity.
- Periodontal abscess: An infection of the periodontal tissues, which could be caused by trauma or pre-existing periodontal disease, leading to a painful lump and sensitivity.
- Gingival cyst or abscess: A cyst or abscess on the gum tissue could cause a painful lump and be irritated by the trauma.
- Do Not Miss diagnoses
- Osteomyelitis: Although less likely, an infection of the bone tissue could be a consequence of the trauma, especially if there was an open wound or if the patient has a compromised immune system. Osteomyelitis can be severe and requires prompt treatment.
- Cellulitis: A spreading bacterial infection of the skin and subcutaneous tissues, which could be a complication of the initial trauma, especially if the skin was broken.
- Eruption cyst: If the descending tooth is erupting, an eruption cyst could form, which might be painful and could be irritated by the trauma.
- Rare diagnoses
- Odontogenic keratocyst: A rare type of cyst that can occur in the jaw, potentially causing a painful lump, although it is less directly related to the traumatic event.
- Ameloblastoma: A rare, benign tumor of the jaw that could cause a lump, but it would be an unusual coincidence with the trauma and is less likely to cause acute pain unless it has become infected or is putting pressure on surrounding structures.