Parulis / Fistula Granuloma
A parulis or fistula granuloma (gum boil), is a
common lesion that develops exclusively on the
gingiva (gum).

It is characteristically found at the opening of the sinus
tract of a
peri-apical or periodontal fistula.  Infection from
the tooth / socket has tracted through the bone and opens
onto the
gingiva.  It can vary in size (dependent on the
amount of pus being produced and the state of the
person’s immune system).
Clinically, the lesion presents as a painless, exophytic granulation tissue mass,
identical to
pyogenic granuloma.

Removal of the source of infection (that is, root canal treatment of the tooth or
tooth extraction) normal resolves the
parulis though it is not uncommon for
parulides to become autonomous if there is still a focus of infection ‘feeding it’.

parulides can develop on the skin whereby the infection has totally bypassed
gingiva and tracts out on to the skin.  This is often in the area of the chin and
the infection is associated with
non-vital (i.e dead) lower incisors.

OMFS department gets involved as the dermatologists have tried to treat the
parulis but have failed.  I have seen quite substantial parulides associated with
lower molars as well.

Useful Websites:


New Zealand Dermatology
Last Updated 24th March 2015
Photos of Parulides (Gum Boils)