Blood disorders or diseased conditions like acute leukemia, lymphoma, or aplastic anemia. Nutritional deficiencies, especially with the incidence of a vitamin C deficiency or scurvy. Hormonal states of variation as in pregnancy and puberty. The inflammatory response seen on the gingiva would be localized or generalized because of the following conditions: The systemic or bodily conditions that are linked to gingival hyperplasia and hypertrophy are diverse. There is evidence regarding the mechanism of action of these drugs as they can impair the secretion of collagenase by the gingival fibroblast cells resulting in an excessive accumulation of gingival collagen. Calcium Channel blockers and Cyclosporine/immunosuppressant constitute 30% and 10-20 % of cases with gingival enlargement. Immunosuppressive drugs like Cyclosporine.Īccording to research and medical literature, anticonvulsant therapy-related gingival enlargement constitutes the major number of cases or peak incidence of around 50%, especially with Phenytoin, also referred to as Dilantin Hyperplasia. Antihypertensives - calcium channel blockers such as Nifedipine, Verapamil, and Amlodipine. Anticonvulsants - Phenytoin, Lamotrigine, Phenobarbital,Topiramate, Primidone, Ethosuximide,Vigabatrin etc. It occurs commonly in these patients on the following medications : Medication-induced gingival enlargement is featured by fibrous overgrowth on the gingiva or the superimposed boggy appearance of the gums. Orthodontic appliances may also cause inflammatory enlargement occasionally. Nicotine in any form of tobacco is not only toxic but also irritant and can be a potent carcinogen. Smoking - a well-established risk factor for gingival and periodontal disease as it alters the microflora and physiology of the oral immune response. 
Poor dental hygiene and maintenance - promoting the growth of bacterial biofilm or plaque on the tooth surface (enamel), leading to gingivitis and periodontitis or bone loss surrounding the tooth.This type of enlargement is more often associated with a local specific cause that results in a reddish, soft, shiny texture, and bleeding appearance of the gingiva or gums. What are the reasons for bleeding gums? What Are the Types of Gingival Enlargements? The modalities for managing gingival hyperplasia are mainly dependent on the etiology and may be invasive or non-invasive depending on the extent of inflammation or enlargement.
Drug-induced/medication-induced enlargement.Gingival hyperplasia though multicausative in origin, still mainly stems from three major causes: What Is the Etiology of Gingival Enlargements? Though these two terminologies are considered different because of microscopic distinctions, the disease process is the result of gingival inflammation, referred to as gingival enlargement. Hyperplasia is an increase in the number of cells, while hypertrophy is an increase in the size of individual cells. Gingival inflammation may be limited only to a particular quadrant or specific area in between or surrounding the teeth in the oral cavity or maybe generalized in all quadrants. It is a localized or generalized irregular enlargement of the marginal or attached gingiva due to chronic inflammation of the gum tissues locally or systemic induced inflammatory changes by drugs, nutritional deficiencies, hormonal changes or abnormalities, or autoimmune changes and infections. What Is Gingival Hyperplasia or Hypertrophy?
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