Boy With Facial Pain

An 8-year-old boy presented to the immediate care with a 2-day history of right facial pain and swelling (Fig 1). He had a right lower molar cavity filled a year ago with a stainless-steel crown that chipped a month ago. Abnormal vital signs included a temperature of 38.1°C. He was alert, oriented, and hemodynamically stable with lower right facial swelling with tenderness, erythema, and warmth. The inferior border of the mandible could not be palpated, and there was swelling and erythema to the right mandibular buccal vestibule overlying a right 1st mandibular molar primary tooth.