Oral Gingival Inflammation and Enlargement
Etiology of Gingival Swelling
Swelling of the gingival tissues (gums) is a common clinical presentation resulting from a variety of underlying causes, primarily inflammatory processes. These causes range from localized infections to systemic conditions.
Infectious Agents
- Bacterial Plaque: The primary causative agent in gingivitis, an early stage of periodontal disease. Accumulation of bacterial biofilm leads to inflammation and swelling.
- Fungal Infections (e.g., Candidiasis): Can cause localized gingival swelling, particularly in immunocompromised individuals.
- Viral Infections (e.g., Herpes Simplex Virus): May manifest as gingival lesions accompanied by swelling and pain.
Non-Infectious Factors
- Periodontal Disease: Advanced stages (periodontitis) involve significant gum inflammation, swelling, and potential bone loss.
- Trauma: Physical injury to the gums, such as from poorly fitting dentures or accidental biting, can induce swelling.
- Medications: Certain drugs, including phenytoin (an anticonvulsant) and calcium channel blockers, can lead to gingival overgrowth as a side effect.
- Hormonal Changes: Fluctuations in hormone levels, particularly during puberty, pregnancy, and menopause, can affect gingival susceptibility to inflammation.
- Systemic Diseases: Conditions such as leukemia, diabetes, and vitamin deficiencies can impact gingival health and contribute to swelling.
- Allergic Reactions: Allergic responses to certain substances, such as toothpaste components, can cause gingival inflammation and swelling.
- Genetic Predisposition: Certain individuals may have a genetic predisposition to more severe gingival inflammation and response to plaque accumulation.
Clinical Presentation and Diagnosis
Diagnosis involves a thorough clinical examination, including assessment of gingival inflammation, probing depths, and radiographic imaging to evaluate bone support. Medical history and review of medications are crucial to identify potential contributing factors.
Treatment Approaches
Treatment strategies vary depending on the underlying cause. They may include improved oral hygiene practices, professional cleaning (scaling and root planing), antimicrobial therapy (for infections), medication adjustments (where applicable), and surgical interventions in advanced cases of periodontal disease.