patient age 40 /m,swelling with severe pain and fever for 2. days. such swelling is from 3 days.

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From picture it is palatal abscess i&d and antibiotics improve oral hygiene CT pns to see the extent send spcimen to rule out malignant minor salivary gland and maxilla

Palatal abscess due to chronic suppurative Periodontitis in a chronic smoker . * by seeing clinical visuals the pt might be addicted chronic smoker . * to improve any infection in oral cavity the scaling and removal of stains is very important. * any mobility of the teeth for both upper and lower arch should check * due to heavy smoking the gingival tissue become hyper pigmentation and swollen due to inhalation of heated smoke . * check both upper and lower arches for periodontal pockets in and around the upper and lower gingival tissue * smoking , tobacco chewing habit should stop. * stop if any nut powder chewing and pungent powders panparag. Raja khyni and others . * councilling should be given to patient on adverse effects from smoking habit . * brothers, visual videos should project and educate for the patients not to smoke . * metrogyl 400.mg thrice daily for 7.days for suppuration from gum tissue. * mouth wash chlorhexidine 3 times should gargle . * b complex tab once daily for vitamin supplie mentation . * any decayed teeth should be filled with composite resin . * the food impaction in the caries cavities wil enhance the foul smell and aggravate the acidic nature of the oral cavity results tissue damage and ulcerations in the mouth . * keep and hold deeply warm salt water for 5 to 8 minutes will help to kill the harmful bacteria by deosmosis process . * the palatal abscess at the hard palate is due to chronic suppurative piriodontitis and pockets will spread in to palatal portion and causes palatal abscess .

Respected Dr.Jana Rama thank you for reply, actually the problem is they people don't go to dentist for the solution of problem, they only want that Fever ,pain and swelling to be subsided . For future of disease they don't worry. Financially also poor.
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First diagnosis should be done with radiographs. An opg and iopa with all the incisors. If required then proceed for a ct scan . Mostly it can be a palatal abcess or a cyst. Treatment has to be proceeded after diagnosing . Temporarily for fever an antipyeretic should be started and an analgesic for pain. If its an abscess then prior to treatment antibiotics shd be started

Plz proceed with broad spectrum antibiotics and if required analgesics, opg/IOPA of all teeth adjacent to the swelling, check vitality of teeth adjacent to lesion, aspirate the contents using a wide bore needle and make note of color of aspirate and get protein estimation done. Based on these clinical, radiographic and biochemistry investigations we can proceed further.

This is abcess but due to 11 n 21 teeth as they are severely attrited n broken. of course general condition is poor n compromised. rct or extraction of teeth involved will help considering all other medical parameters.

It's a case of palatal abscess. Maxillary occlusal radiographs are needed to find out the extent of the lesion

Take iopa of anterior tooth. Give antibiotic as systemic involment is there. Do incision and drainage

@Dr. Barun Kumar

Vitality can be affected bcoz of the lesion itself better to go ahead with biopsy it can be midpalatine cyst or radicular cyst but there are chances that it can be a salivary gland neoplasm

According to me first stop habit and go for opg and do aspirations of palatal cyst. Aspiration is positive than go for inucleation Before education do RCT of effected tooth.

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