Gingivitis not of plaque origin
Gingivitis of non-plaque origin are not a single disease but the inflamed gums related to the presence of a number of other disorders or conditions. Some areas of the gum are red, some may be ulcerated and other areas may have thickened white looking appearance called hyperkeratosis.
Signs and symptoms
Desquamative gingivitis involves lesions of both the attached gum and the rest of the oral mucosa. Unlike plaque-induced inflammation of the gums (gingivitis) which occurs at the margins between the tooth and the attached gum, desquamative gingivitis usually extends to a much wider oral distribution. However the conditions usually do not result in much bone loss around the teeth.
Differential diagnosis
Desquamative gingivitis is a descriptive clinical term, not a diagnosis. Other skin changes or conditions are usually identified within these patients and these conditions are:
- Oral lichen planus;
- Cicatricial pemphigoid or less commonly bullous pemphigoid;
- Pemphigus vulgaris;
- Dermatitis herpetiformis (associated with Gluten Intolerance and Coeliac Disease);
- Lupus erythematosus;
- Crohn disease;
- Sarcoidosis;
- Chronic ulcerative stomatitis;
- Leukaemia;
- Chronic bacterial, fungal, and viral infections;
- Reactions to medications, mouthwashes, and chewing gum.
If these conditions are found we will usually refer you to your medical practitioner and an Oral Medicine Specialist. Patients are usually placed on a recall maintenance program to control the plaque as many patient find it painful to brush their teeth normally.
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