Ever heard of Large Gums?!

As the title implies, there is a condition that might affect the gums known as gingival enlargements and it may result in the formation of false pockets. Its characterized by the increase in the bulk of the gums as result of certain systemic conditions or side effects of some drugs.

maxresdefaultThere many classifications of gingival enlargements, they occur as a result of:-

  1. Chronic Inflammation
  2. Adverse effects of certain drugs
  3. Enlargement associated with certain systemic diseases or conditions
  • How chronic inflammation can cause gingival enlargements?

Chronic inflammation is the most common form of gingival enlargements, they occur due to prolonged irritation of the gums as a result of poor oral hygiene, misalignment of teeth, improperly contoured dental restorations, food impaction, irritation from orthodontics appliances & mouth breathing habit seen more commonly in the upper incisors, & canines.

They are painless unless complicated by infection or injury & they originate as slight ballooning of the margin of the gingiva or interdental papilla (the gums between the teeth) which is usually red or bluish red in color, bleeds easily & soft.

Treatment varies from patient to patient, in some cases, removal of the cause of the irritation may resolve the problem, others may require gingivoplasty (recontouring of the gums). Consult your periodontist to determine the best treatment plan for you.

  • Gingival Enlargements as a result of adverse effects of drugs

There are certain drugs that may predispose to gingival enlargements such as:

  1. Phenytoin (Dilantin sodium)
  2. Cyclosporine
  3. Nifedipine
  4. Sodium Valporate

(Refer to the chemical name of the drug rather than the trademark)

Phenytoin associated gingival enlargements is not related to the duration or concentration of the drug in saliva. It starts as beads like enlargements of the margins of the gums, these will unite and develop a massive fold covering most of the tooth and will often interfere with occlusion. The lesion is mulberry shaped, firm & pale pink with a small lobulated surfaces without tendency to bleed. It can be severe in the incisors and canines and occurs in areas where teeth are present. The enlargement is chronic, slowly increases in size and may recur after surgical removal.

Cyclosporine on the other hand is an immunosuppressive drug that has many side effects including, gingival enlargement, hypertension, hypertrichosis (increase in hair where it normally doesn’t present at specific sites of the body), & nephrotoxic (toxic to kidneys). Gingival enlargement here is more vascularized than Phenytoin associated gingival enlargement. It occurs in children more commonly and its magnitude is related to the concentration of the drug in the blood.

Nifedipine is a drug given to people with heart conditions and can induce gingival enlargements in 20% of the cases.

Treatment here will be based on the patients conditions, the reasons he/she is taking the drug & is done with the consultation from the patient’s physician.

PGE

  • Hormonal Gingival Enlargement

The bulk of the gingiva can increase in puberty and pregnancy due to hormonal changes that occur during these periods. Pregnancy, however, doesn’t cause the condition, its just the altered tissue metabolism that can accentuate gingival enlargements. It can occur in 10-70% of the cases.

GE
Gingival Enlargements may also be seen in patients with orthodontic appliances.
  • Leukemic Gingival Enlargements

As the name implies, gingival enlargement can occur in patients with acute leukemia and in fact it can be a sign that the patient is suffering from leukemia if he hadn’t been diagnosed with. Gingival enlargements here is characterized by bluish red gingiva, moderately firm, bleeds spontaneously on slightest irritation, & can be complicated by Acute Necrotizing Ulcerative Gingivitis.

LGE

So, what do you know about bulky gums? I will read each and every comment.

If this article has benefited you, please let me know cause it really makes my day!

Haider Maitham, DDS

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4 thoughts on “Ever heard of Large Gums?!

  1. I think this is one of the most important information for me. And i am glad reading your article. But wanna remark on few general things, The site style is wonderful, the articles is really nice : D. Good job, cheers
    salomon x celebrate

    Liked by 1 person

  2. Iˇm not positive the place you’re getting your info, but great topic. I must spend some time finding out much more or figuring out more. Thank you for magnificent information I used to be looking for this info for my mission.

    Liked by 1 person

    1. Hello,

      All the topics I write here is about what I have studied in my dental school. If I have used information from a book, I would have included it as a reference in the topic itself. All information you see here in this blog are valid and correct, outdated topics will have “outdated” word in the title itself. The same applies for “updated” topics.

      For that particular article, I have gathered information from my knowledge and from our professor’s “Salem Abu Fanas” lecture handouts where he used it as a part of explanation of his presentation.

      Thank you for your comment and wonderful presence!

      Cheers!

      Like

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