Gingival Hyperplasia / Gingival Enlargement

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What is Gingival Hyperplasia?

Gingival hyperplasia is an excessive growth of gum tissue around the teeth due to increase in the number of cells in the gum tissue. Gingival hyperplasia is an increase in the size of the gingiva (gums). It is a common feature of gingival disease. Gingival hyperplasia is also known gingival overgrowth, or hypertrophic gingivitis.

What are the Causes of Gingival Hyperplasia?

  • Inflammation - Gingival (gum) overgrowth is often caused by inflammation and may be localized or generalized. The inflammation can be caused by plaque build-up on the teeth from food, bacteria, poor oral hygiene, dental braces, oral cavity surgeries, gingivitis, periodontitis and oral infections. Gums affected by this condition are mostly tender, soft, red, and bleed easily. This condition usually resolves with proper oral hygiene practices such as tooth brushing and flossing to remove the plaque and irritants on the teeth.
  • Medications- The gum tissues in such cases are usually firm, pale pink, do not bleed easily and are not tender. This type of gingival enlargement may resolve partially or completely when the medication is discontinued. Drug induced gingival overgrowth is a side effect associated mostly with anticonvulsant drugs, immunosuppressant drugs and calcium channel blocker drugs such as Amlodipine to treat high blood pressure
  • Vitamin C deficiency
  • Smoking
  • Overcrowded teeth
  • Hormonal imbalances during pregnancy and puberty-The condition usually improves once the underlying cause has been treated. In the case of pregnancy, gum enlargement improves once the baby has been delivered
  • Systemic diseases such as diabetes, leukemia, HIV infection
  • Genetic predisposition-Hereditary gingival fibromatosis (HGF) and neurofibromatosis are rare hereditary conditions that usually develop during childhood. The gingival overgrowth from this condition is caused by an overproduction of collagen, a type of protein found in the gums. In some cases the gums cover major parts of the tooth surfaces or cover them completely
Causes of Gingival Hyperplasia

What are the Symptoms and Signs of Gingival Hyperplasia?

The visible signs and symptoms of gingival hyperplasia include -

  • Swelling of the gums
  • Pain and discomfort in and around gums
  • Redness and bleeding of gums
  • Infection and pus formation
  • Bad breath
  • Loose teeth that may fall
  • Plaque build-up on the teeth and bleeding
  • Gum enlargement may interfere with chewing or speech
  • Looks unsightly and may lead to psychological problems.

In more severe cases, the gums can completely cover the teeth and can affect the teeth alignment. If your teeth are covered, they will be difficult to clean and this could increase your risk of developing gum disease.

  • If you develop gingival overgrowth during childhood, it could affect the tooth eruption process where the teeth erupt and become visible.

Microscopic examination of the gums shows an abnormal proliferation of gums cells.

Symptoms and Signs of Gingival Hyperplasia

How do you Diagnose Gingival Hyperplasia?

Most cases of gingival enlargement are readily diagnosed after the dentist takes a thorough medical history and performs an oral examination. In rare cases, further tests such as blood studies or a biopsy may be necessary to determine the exact cause of your gingival enlargement.

How do you Treat Gingival Hyperplasia?

Treatment of gingival hyperplasia often depends on the underlying cause.

  • In most cases improved oral hygiene can prevent or reduce severity of symptoms.
  • If the cause is gingival inflammation, then proper oral hygiene techniques such as removal of bacterial plaque by thorough tooth brushing and flossing may resolve this condition.
  • Use of antiseptic mouthwashes or a course of antibiotics to treat the oral infection will be helpful.
  • However if the overgrowth of gums is due to medication then the drug should be discontinued.
  • Doctors may recommend gingivectomy (surgical removal of overgrown gum tissue) for severe cases. Surgical procedures include laser excision and periodontal flap surgery.
  • Devices that look like mouth guards are sometimes used to try and limit the rate of growth of the gum tissues.

However, if the root cause is not treated, the gum enlargement will return and surgery may have to be performed repeatedly.

Treatment Options for Gingival Hyperplasia

How to Prevent Gingival Hyperplasia?

  • Good oral hygiene - Brush teeth after meals to remove residue sticking to the gums. Have regular dental checkups.
  • If it is a case of drug-induced gingival hyperplasia, then you must stop taking the medications and should opt for alternative drugs for reducing its effects on the gums.
  • Avoid intake of foods with sugar content because they can trigger gingival hyperplasia. Children are most affected by gingival hyperplasia as they consume more sticky sweets and also because they do not take proper care of their teeth. It is recommended to supervise oral cleanliness in children.
  • Natural remedies such as eucalyptus oil, cloves, green tea, turmeric, saline mouthwash, baking soda, aloe vera, tea tree oil, guava leaves, mustard oil and salt paste are useful in the initial stages.
  • Intake of foods with high vitamin C content such ascitrus fruits, guava, gooseberry, strawberries, kiwifruit, broccoli, cabbage and fresh leafy vegetables is recommended to maintain healthy gums.

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