My patient is an 84 year old female (white european ancestry). She appears to good health. She appears cognitively sharp. She take levothyroxine, 81mg ASA, latanoprost, aldendronate, magnesium, and multivitamin.

I saw her April 17, 2024 for a limited exam. Notes and photos from the exam follow...

Patient concern/complaint: LR-Tissue below teeth has a sore. Pt noticed it about 4-5days ago. Sore/tender to touch. Has gotten a little worse since it first presented. No changes in health or meds. No recent illnesses.

OBJECTIVE FINDINGS Tooth/Area: #30 area Clinical Findings: ~Generalized gingival inflammation #29-31 ~Sloughing tissue #29/30 B vestibule. ~Perio Probes: #30 - 6mm pocket MB & 6mm ML w/ BOP. ~Percussion #28,29,30,31 - WNL ~Vitality/Cold - #28 WNL, #29 No response, #30 No response, #31 WNL. ~Tooth Sleuth LR - WNL ~Pushing pressure LR - WNL Radiographic Findings: PA - #30 radiographic calc. No PARL or widening of PDL. area of bone defect M #30

Assessment/Diagnosis: Unclear diagnosis: Uncertain if tissue or tooth related.

PLAN - TREATMENT TODAY/FUTURE Rec waiting additional 2wks to see if symptoms come into clearer focus. Rec pt come in earlier than scheduled HYG appt due to radiographic calc

I saw her last week (May 6). The soft tissue lesions present on April 17 have resolved, but she has new lesions similar to previous LR lesions but now UR. See photos below...

This photo is #29-30 area. Note that lesion from April 17 is resolved.

The following photos are of a new lesion UL area #4-5 buccal.

Any ideas what this is?