History of the present illness

This 61-year-old female was referred by her dentist to a periodontogist for evaluation of an enlarging exophytic, slightly lobular, red and ulcerated gingival swelling between teeth #s 8 & 9 (Figure 1).  The area was reported to be slightly painful; it was also reported that the lesion was of cosmetic concern to the patient.  She is a mouth-breather and had heavy sub-gingival calculus.     

Figure 1. This photograph was taken at the first periodontology clinical visit.  Note the red, lobular gingival swelling between teeth # 8 & 9 and slightly extending to the interproximal area between teeth #s 9 & 10.