<s>[INST] Hello, I have found a 5 mm hard  non tender lesion in alveolar vestibular fold over my daughter's right top premolar. She is 9 years old. It was 2 days ago. It's hard, sharply demarcated with distinct borders, painless. I did not notice any surrounding LAD. I am a family NP and am a bit worried. Lisa [/INST] thanks for your query, i have gone through your query. the non tender lesion over the premolar region could be a periapical cyst or fibrosed abscess secondary to tooth infection or exostosis. consult your oral physician and take radiograph to rule out infection. if it is tooth infection it has to be root canal treated. if it is exostosis then no need of treatment its a excessive bone formation it wont trouble. i hope my answer will el you. take care. </s>