Abscess Pain Progression — NDEB AFK MCQ
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Correct answer: D — Diffuse → localised → spontaneous resolution with fluctuance
The typical pain progression in an acute dentoalveolar abscess follows: initial diffuse, poorly localised pain (periapical periodontitis, inflammation confined to cancellous bone) → localised pain and tenderness as the infection approaches the periosteum (subperiosteal abscess, intense pressure pain) → paradoxical pain relief when the periosteum perforates and pus enters the soft tissues (reduced pressure) → localised fluctuant swelling (submucosal or subcutaneous abscess). Understanding this progression helps in clinical assessment — pain relief with swelling suggests progression, not resolution.
Reference: Hupp – Contemporary Oral and Maxillofacial Surgery, 7th ed., 2019