What Is Gingival Hyperplasia?

Gingival hyperplasia refers to the increase in gum volume caused by the increase of cellular components of gingival tissue, which can be seen in gingival tissue infectious diseases caused by plaque biofilms, and also non-inflammatory changes caused by factors other than local stimuli.

Basic Information

English name

gingivalhyperplasia

Visiting department

Stomatology

Common causes

Mouth breathing, poor oral hygiene, medicines, disordered occlusal relations, leukemia, family genetic factors

Common symptoms

Gingival margin thickened, gingival nipples rounded, spherical, red

Causes of Gingival Hyperplasia

Mouth breathing

Nasal diseases often cause mouth breathing, and the mouth is stimulated by air for a long time, which leads to hyperplasia of the gums.

2. Poor oral hygiene

Because the teeth are not brushed for a long time, food residues stay in the gingival sulcus, and tartar is formed by the action of bacteria. Gum congestion, redness, swelling and hyperplasia, sometimes bleeding after a slight stimulation, causing inflammatory gum hyperplasia.

3. Drugs

If long-term treatment of epilepsy and cardiovascular drugs phenytoin sodium, nifedipine are equal, it will cause gum hyperplasia.

4. Disorganized bite relationship

Crowded front teeth, disordered arrangement, deep occlusion and other deformities of the teeth and jaws, causing the gums to often be stimulated by food and hyperplasia.

5. Leukemia

With leukemia, gingival hyperplasia can occur.

6. Familial genetic factors

Clinical manifestations of gingival hyperplasia

Normal gums are pink, and the gingival margin should be thin and close to the tooth surface. When the gingival hyperplasia occurs, the gingival margin becomes thicker, the gingival papilla is round and blunt, and it is spherical, and the color can be bright red, dark red or pink.

Gingival Hyperplasia

Diagnosis is based on differences in medical history, medication history, gum color, shape, texture, and hyperplasia site.

Chronic gingivitis

The presence of dental plaque and tartar; changes in gum color and shape: bright red or dark red gums, thickened gingival margins, round and blunt hypertrophy of gingival papillae, and sometimes spherical hyperplasia. A few people with severe inflammation may have gingival erosion or granulation. The gums are sometimes soft and fragile. During exploration, the gingival sulcus bleeding, the bottom of the gingival sulcus should be located at the enamel cementum, no clinical attachment loss. Radiographic manifestations of alveolar zygomatic bone resorption.

2. Adolescent gingivitis

(1) The patient is in adolescence; the oral hygiene is fair or poor; the gums are markedly red and swollen, and the gingival nipples often show spherical protrusions, which are bright and soft. Light irritation is easy to bleed, which occurs on the labial side of the anterior teeth. Can have bad breath.

(2) There may be factors such as mismatch, orthodontic appliances, bad habits, etc. The degree of hypertrophy and hyperplasia of the gum does not match the degree of local stimulation, that is, the inflammatory response of the gum tissue is strong.

3. Gingivitis during pregnancy

(1) Inflammation of the gingival margin and gingival papilla can occur in individual teeth or in the entire mouth, but the previous tooth area is heavy. Local irritants such as plaque are present. Generally, there are different degrees of gingivitis before pregnancy. From 2 to 3 months of pregnancy, there are obvious symptoms such as brushing teeth and bleeding gums when eating food.

(2) Gingival tumors during pregnancy occur in the interdental papilla of a single tooth, usually appear in the third month of pregnancy, and rapidly proliferate, bright red or dark purple, irregular shape, may have leaves, pedicled or pedicleless, quality It is soft and easy to bleed. Generally, local irritating factors can be found, such as residual roots, calculus, and bad restorations. After delivery, most pregnancy tumors can gradually shrink on their own, but local irritants must be removed to make the lesion completely disappear.

3. Drug-induced Gingival Hyperplasia

(1) History of systemic diseases and medication history.

(2) The hyperplasia and hypertrophy of the interdental nipples or gingival margins are spherical, mulberry-like or lobulated, pale pink, solid and slightly elastic, and severely hinder chewing. It is more common in the anterior region and can also occur in the entire gum.

(3) It is generally painless and may be accompanied by severe gum inflammation such as bad breath, bleeding from brushing, and periodontal discharge.

(4) Loose and displaced teeth due to hyperplastic gingival compression (most common in upper anterior teeth).

(5) The condition can be aggravated by poor oral hygiene, combined trauma, dental caries, poor fillings and appliances.

4. Gingival fibromatosis

(1) May have family history. A small number of cases occur in young children, the earliest can occur after deciduous teeth.

(2) It can accumulate the gingival margin, gingival papilla, and attached gingiva of the entire mouth, and the maxillary molars are the heaviest.

(3) often cover more than 2/3 of the tooth surface.

(4) The color of the hyperplastic gums is normal, the tissue is tough, and it is difficult to bleed. Sometimes it is difficult to have teeth eruption.

5. Gingival tumor

(1) Gingival nipples are round, oval, and sometimes lobulated tumor-like proliferations. Different sizes.

(2) With or without pedicles. The pedicled is polypoid and the sessile has a broad base.

(3) Soft, reddish (vascular and granulomatous) or hard and tough, pinkish (fibrous).

(4) Generally painless, pain can be felt when ulcers appear on the surface of the tumor.

(5) X-ray film shows local alveolar bone resorption or periodontal ligament widening.

Gingival Hyperplasia Treatment

Gingival hyperplasia varies according to the specific cause.

Chronic gingivitis

(1) Remove plaque, stones and other pathogenic factors that promote plaque accumulation.

(2) Instruct patients to self-control plaque.

(3) Ask patients if there are systemic risk factors that promote disease progression, such as smoking, systemic diseases and conditions (immunosuppression), stress, nutrition, pregnancy, drug use, HIV infection, and drug use, etc., and consider actively taking targeted Measures.

(4) After periodontal treatment, the gingival hyperplasia is still obvious, and surgical resection can be considered.

2. Adolescent gingivitis

Oral hygiene guidance for puberty. Remove local irritants, treat on the gums, and cure if necessary. If necessary, it can also be combined with local drug-assisted treatment, such as gargle, gingival bag irrigation, and topical application. Remove plaque retention factors. For patients with chronic gingival hypertrophy and adverse plaque control, gingival resection can be taken if necessary.

3. Gingivitis during pregnancy

In the first trimester or trimester of pregnancy, consider postponing periodontal treatment to avoid miscarriages or preterm births. Local irritants such as plaque and calculus are removed from 4 to 6 months of pregnancy, but the operation must be gentle to minimize bleeding and pain. Emergency periodontal treatment can be performed at any time during pregnancy. Use antibiotics and other drugs with caution. Emphasize self-plaque control and regular periodontal maintenance. The hyperplasia of the gingival is considered to be postponed until delivery after surgical resection, which has hindered eating. Large gestational gingival tumours may be considered for surgical resection within 4 to 6 months of pregnancy.

4. Drug-induced Gingival Hyperplasia

Without affecting the control of systemic diseases, replace the drugs that cause gum growth. Removal of local irritants such as plaque and calculus, elimination of factors that cause plaque retention, and guidance of plaque control in patients. After treatment, the gingival hyperplasia of most patients can be significantly improved or even subsided. For patients with obvious gingival inflammation, adjuvant drug treatment can be used to rinse the gingival bag with 3% hydrogen peroxide solution, and an antibacterial and anti-inflammatory drug is placed in the bag. For those who have not completely resolved the gingival hyperplasia mentioned above, surgical treatment of gingival resection and shaping can also be performed with flap flap combined with gingival resection. Clear doctor's order to avoid recurrence after surgery.

5. Gingival fibromatosis

Removal of local irritants such as plaque and calculus, elimination of factors that cause plaque retention, and guidance of plaque control in patients. Surgical treatment, mainly gingival angioplasty, can also be combined with flap resection surgery.

6. Gingival tumor

Remove irritants and remove them surgically. Surgical resection should be thorough, make an incision on the normal tissue around the base of the mass, and remove the mass along with the periosteum, part of the alveolar bone at the base and the periodontal tissue of the corresponding site to prevent recurrence. A periodontal protector is placed on the wound. If the teeth around the gingival tumor have become loose, they should be removed at the same time, and the affected periodontal membrane and adjacent bone tissue should be removed at the same time. After recurrence, it is generally still removed according to the above method. If recurrence is repeated, the affected tooth should be removed at the same time.