Gingival Overgrowth Quiz (ODS Learning Outcomes)

Gingival Overgrowth: Clinical Features and Management

• Clinical Features of Gingival Overgrowth:

  • Cellular hypertrophy: Increase in individual cell size.
  • Fibrosis: Accumulation of collagenous connective tissue.
  • Cellular hyperplasia: Increase in the number of individual cells.
  • Oedema: Abnormally large fluid collection in intercellular spaces.

• Causative Factors of Gingival Overgrowth:

  • Inflammatory enlargements: Chronic and acute inflammation.
  • Drug-induced enlargements: Certain medications.
  • Systemic disease-related enlargements: Conditions like leukemia.
  • Neoplastic enlargements: Gingival tumors.
  • False enlargements: Misinterpretation of underlying bone or dental tissue enlargement.

• Assessment Measures for Gingival Overgrowth:

  • 0: No enlargement.
  • 1: Enlargement limited to interdental papillae.
  • 2: Enlargement involves papillae and gingival margins.
  • 3: Enlargement covers more than ¾ of the tooth.

• Classification of Gingival Overgrowth:

  • Localized: Limited to a single tooth or group of teeth.
  • Generalized: Involves gingiva throughout the mouth.
  • Marginal: Confined to gingival margins.
  • Papillary: Limited to interdental papilla.
  • Discrete: Isolated enlargement (e.g., abscess).
  • Diffuse: Involves gingival margin, attached gingiva, and interdental papilla (often linked to leukemia).

• Impact of Gingival Overgrowth on Oral Health and Patient Well-being:

  • Aesthetics: Unattractive appearance.
  • Functional difficulties: Food impaction, difficulty eating, impaired speech.
  • Pain: Discomfort during eating.
  • Increased caries risk: Difficulty cleaning leads to more cavities.
  • Periodontal disease risk: Increased susceptibility to gum disease.
  • Tooth movement: Pressure on teeth may cause shifts.
  • Mouth breathing: May lead to dry mouth.
  • Halitosis: Bad breath.
  • Low self-esteem: Affect self-confidence and social interaction.
  • Mental health issues: Potential for isolation and depression.
  • Poor oral hygiene: Difficulty maintaining clean teeth.
  • Underlying medical condition: Compliance issues due to other health factors.

• Potential Management of Gingival Overgrowth:

  • Professional care: Scaling, plaque removal, and professional cleaning techniques.
  • Oral hygiene instruction: Proper brushing and flossing techniques.
  • Interdental cleaning: Flossing or interdental brushes, particularly in cases with severe overgrowth.
  • Medication assessment: Consult prescribing physician about any potential link between the medication and the overgrowth.
  • Referral: Collaboration with a general practitioner if medication is a suspected cause.

• Drug-Induced Gingival Overgrowth (DIGO):

  • Associated medications: Anticonvulsants, immunosuppressants, and calcium channel blockers are among the main culprits.