I have a case which I am allowed to share.

A female 29 y.o. patient who has been using homoeopathy (mostly constitutional or prescribing for chronic problems) for approx. the last ten years presents with an abscess on her gum.

The abscess is located between the central and lateral incisor on the right lower side.

Earlier this year (around Jan-Feb) patient can't exactly remember she was eating a pear which was crunchy (like an apple) as she bit into it a shard of pear cut into her gum (where the abscess is now), there was some bleeding but it stopped on it's own accord, the patient cleaned out any pear that was stuck in the gum line and she found that there was a little flap of ripped gum that never healed. This flap was always there and was painless so she never went to the dentist or mentioned this incident in consultation until now.

Around six weeks ago this small gum flap swelled up into an abscess which may exude a small amount of fluid which is almost always clear, once or twice there has been a tiny drop of blood in the clear fluid. The only reason there was a clear fluid discharge is because the patient thought to put a cotton ball soaked in "Swedish Bitters" locally on the abscess to try and have it expel it's contents. (Swedish Bitters is a herbal blend of bitter herbs.) Only a small amount of fluid came out at any attempt, she tried maybe five or six times on different occasions.

The abscess is painless, patient uses an electric toothbrush and can brush right on top of abscess and it is still painless. The abscess is currently 1cm wide at the widest point (near the gum line) and 1cm high. The shape of the abscess is like that of an arrow head it tapers at the top and it lies flat against the tooth so you can't see that there is any lump until the patient pulls down her bottom lip. The color is for the most part the same as the healthy gingiva, there is a slight red tinge at the top of the abscess.

There was no trauma (either physically to the area or emotional trauma) at the time that the abscess came up i.e. six weeks ago.

The patient can floss between the teeth that the abscess is over with no pain or bleeding.

The rest of the gums are healthy. The patient has no history of any dental fillings. The patient is missing both her upper canine teeth (missing teeth run through the family.)

There is no problem with eating the lump does not interfere at all (I was hoping for a hot/ cold modality.)

I am thinking that this may be a case of gingivitis that even if the original pear shard was removed that some other food may have become lodged and caused the swelling?

The patient is otherwise well.

Any suggestions as to how to tackle this case? I am just a little bit stumped and struggling to get started as to how to tackle this one.

TIA

Carol