Gingival Hyperplasia – Causes, Clinical Features, Treatment

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Dr Sukanya Goswami
Sukanya has done BDS. She is a dentist, a blogger, an extrovert, and a travel enthusiast. She is also a spiritual believer. When she is not working, you can find her reading books.

Gingival enlargement is commonly referred to as gingival hyperplasia or hypertrophy. It is typically characterized by an abnormal overgrowth of the gum tissue. Several causes can lead to gum disease and excessive inflammation of the gums. Some of them include poor oral hygiene, medications, hereditary condition, and systemic causes.

Often, gingival hyperplasia can be clinically seen as red, swollen, and bleeding gums. It is a painful condition that may regularly interfere with chewing and biting. Treatment of gingival hyperplasia usually depends on the type of cause. Sometimes, a simple oral hygiene routine may help to subside the symptoms of gingival hyperplasia. However, in severe cases, surgical intervention may be required.

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Today’s article will highlight some of the critical features of gingival hyperplasia. Furthermore, we will discuss the causes and treatment of this unique condition.

What is gingival hyperplasia?

Gingival hyperplasia is also known as –

  • Gingival overgrowth
  • Gum enlargement
  • Hypertrophic gingivitis

It is characterized as an overgrowth of the gums around the teeth. It can be a painless condition. However, in most cases, the patient may feel severe pain and discomfort. (1) Although there are several causes of gingival hyperplasia, it is believed to be caused by inadequate oral hygiene. Additionally, it can also occur as a side effect of certain medications.

Untreated cases of gingival hyperplasia may often lead to the development of gum disease. Furthermore, the excessive swelling of the gums may affect the alignment of the teeth in the dental arch.

What causes gingival hyperplasia?

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Typically, four primary causes can lead to gum enlargement or overgrowth. The origins of gingival hyperplasia are listed below –

Inflammatory gingival hyperplasia

As the name suggests, this type of gingival hyperplasia is caused by gum inflammation. Often the underlying cause for gum inflammation is poor oral hygiene. Plaque and bacteria buildup on the tooth surface is a potential cause for gum disease.

The inflammation caused by inadequate oral hygiene makes the gums tender and red. Moreover, it triggers gum bleeding. It is essential to follow proper oral hygiene routine such as brushing and flossing to improve the gum inflammation.

Drug-induced gum enlargement

Drug-induced gingival hyperplasia is typically caused by prescribed medications such as –

  • Antiseizure drugs
  • Immunosuppressants (2)
  • Calcium channel blockers – medicines used to treat high blood pressure and heart conditions

Often drug-induced gum enlargement can be resolved by taking an alternative medication or stopping the use of the current drug.

Systemic gum enlargement

Some of the physiologic causes of gingival hyperplasia may include –

  • Pregnancy and hormonal imbalance
  • Blood-related diseases like anemia and leukemia
  • Diabetes
  • HIV
  • Crohn’s disease
  • Lymphoma
  • Vitamin deficiencies

Treatment of the underlying systemic cause usually helps to improve the gum enlargement. Moreover, proper oral hygiene practices may help to reduce the risk of gum enlargement.

Hereditary gingival hyperplasia

This is a rare type of gingival hyperplasia, which usually causes a slow and progressive enlargement of the gums. It often begins in childhood but becomes noticeable in adulthood. Typically, hereditary gingival hyperplasia is caused by the overproduction of collagen. (3)

What are the signs and symptoms of gingival hyperplasia?

One of the prime characteristics of gingival hyperplasia is red, swollen, and bleeding gums. This condition can be painful and may affect the health of the oral tissues. Some other common symptoms of gingival hyperplasia may include –

  • Sensitive gums – tenderness may increase if the condition is not treated timely (4)
  • Gum inflammation
  • Pain and discomfort
  • Bad breath
  • Excessive plaque and calculus formation on the tooth surface
  • Difficulty in chewing food

Severe cases of gingival hyperplasia can lead to complete coverage of the teeth by gums. Such a condition often makes it difficult to clean the area and affects the oral hygiene. Moreover, it changes the alignment of the teeth in the jaw. Gum disease is another complication of severe gingival hyperplasia.

Gingival hyperplasia in children can lead to delayed tooth eruption, and in some cases, it can cause tooth impaction as well.

What is the treatment for gingival hyperplasia?

Treatment of gingival hyperplasia often depends on the type of underlying cause. In most cases, proper oral hygiene practices may help to reduce the swelling and gradually restore the health of the gums. (5) However, in severe cases, gingival hyperplasia may be treated by the following procedures –

  • Electrosurgery – the gum tissue is cut and removed by applying electric currents.
  • Laser excision – the enlarged gum tissue is cut using a laser. The periodontist may scrape the plaque around the tooth and its roots.
  • Gingivectomy – the inflamed portion of the gums is cut using a scalpel
  • Periodontal flap surgery – after the removal of the gum tissue, the exposed tooth root is covered by healthy gums from the adjacent tooth.

Take away message

Gingival hyperplasia is a unique dental condition that leads to severe enlargement or inflammation of the gums. Often the gums become red, swollen, and tender. In some cases, spontaneous bleeding from the gums may also be noticed.

Typically, gum enlargement is caused by inadequate oral hygiene. Additionally, the use of medications like calcium channel blockers, antiseizure drugs may cause hypertrophy of the gums. Systemic causes such as hormonal imbalance, diabetes, and blood disorders also contribute to gum enlargement. Swollen gums often affect the health of the tooth and surrounding oral tissues. In severe cases, the gums may cover the entire tooth and also change the alignment of the teeth.

It is essential to consult a dentist and treat the cause immediately. Treatment of gingival hyperplasia depends on the type of cause. While proper oral hygiene practices may manage minor inflammations, severe cases of gum enlargement may require surgical intervention.

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