Gingival Hyperplasia

- Enlargement of gums or gingiva is called gingival hyperplasia in the dental terms.

- This occurs due to abnormal multiplication of gingival tissues due to various factors. 

- When an individual is diseased with gingival hyperplasia then the gums become swollen and enlarged. 

- If you are suffering from gingivitis there will be bleeding in the gums as well as tenderness. 

- The teeth get covered with the gums if the infection is too intense. 

- The patient is examined by a dentist and then the patient is sent for further examination if any further complications are seen.

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Causes:

There are several causes of gingival hyperplasia:

- Inflammatory and granulomatous disorders "like Hand-Schuller-Christian syndrome"

- Auto-immune disorders "like plasma cell gingivitis which is associated with allergic and collagenous nature"

- Neoplastic disorders "like acute leukemia and monocytic leukemia"

- Metabolic and storage disorders "like aspartylglycosaminuria, genetic disorders like Cross syndrome"

- Toxicity of drugs.

- Excess of deposition of drugs given to a patient. It is also called as Drug-Induced Gingival Overgrowth (DIGO).

- Immunosuppressant like Cyclosporin, anticonvulsants like valproate, phenytoin, phenobarbital, primidone and calcium channel blockers like nifedipine, verapamil and amlodipine.

Note: Cyclosporin and phenytoin toxicity are the important toxicities caused in a patient especially in case of dental plaque where these drugs get deposited on the tooth.

Causes of Gingival Enlargement is divided into five groups:
- Inflammatory Enlargement
- Enlargement due to systemic /genetic diseases
- Neoplastic enlargement
- False enlargement
- Drug induced enlargement
- Gingival Hyperplasia differential diagnosis

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Diagnosis:

- Mainly done by differential diagnosis.

- IFN-gamma-stimulated gene expression which is important to determine the presence of gingival hyperplasia in the body.

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Treatment:

The treatment of gingival hyperplasia is based on the type and cause of the gingival hyperplasia.

- Improving oral hygiene is the most important factor which will determine the cure rate of the disease.

- Maintain oral hygiene regularly to prevent any further spread of infection.

- Gingivectomy, a surgical procedure to remove the excess of gingival tissue is carried out to manage the condition.

- The drugs which cause toxicities and affect the gingival tissues can be replaced with alternative drug therapies. For instance, in case of immunosupression, cyclosporine can be replaced by tacrolimus which is has less affect in gingival hyperplasia. Nefedipine can be replaced by isradipine as it does not increase the conditions of gingival hyperplasia.

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