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Gingival overgrowth
Figure 33.1 Gingival overgrowth. (a) Gingival overgrowth in a patient in the second trimester of pregnancy. The gingivae are very inflamed and bleed easily and are associated with the presence of generalised plaque deposits. (b) Gingival overgrowth associated with the calcium channel-blocking drug nifedipine. Note the enlarged interdental papillae and deposits of gingival plaque.
Figure 33.2 Causes of gingival overgrowth.
Figure 33.3 The main drugs associated with DIGO.
Figure 33.4 Characteristics of DIGO. The features listed may be seen in DIGO but some also occur in gingival overgrowth related to other aetiological factors.
Figure 33.5 Management of gingival overgrowth.
Gingival overgrowth is a term given to the development of increased gingival bulk that can arise from a number of causes. In many cases there is associated plaque-related inflammation. This may be involved in the development of the overgrowth, but the enlarged tissue contour is difficult to clean and thus acts as a local plaque retention factor.
The appearance of the overgrowth varies. The tissue may be red, swollen and inflamed and tend to bleed easily, or it may be pink and fibrous if associated with increased collagen formation (Fig. 33.1). If the gingival tissue is invaded by neoplastic cells or granulomas then it may appear more solid but may still present with a superimposed inflammatory component. The clinical appearance cannot be considered as diagnostic of any particular aetiology.
Problems experienced by patients with gingival overgrowth are:
Readers are referred to textbooks in oral medicine for greater depth on this subject (Chapple and Hamburg, 2006). Drug-induced gingival overgrowth (DIGO) is covered in the following section, while the other main causes are listed below (Fig. 33.2/>
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