II. Definitions

  1. Gingival Hyperplasia
    1. Non-inflammatory thickening of gum tissue (via increased cell number) overlying the alveolar ridge
  2. Gingival Hypertrophy
    1. Abnormal gum enlargement (via swelling of existing cells)

III. Pathophysiology

  1. Normal pathway of Collagen degradation is disrupted, allowing for increased extracellular Collagen deposition at gums

IV. Risk Factors

  1. Increased Dental Plaque
    1. Increased dental Plaque is associated with worse Gingival Hyperplasia
  2. Male Gender (RR 3)
  3. Age <40 years old
  4. Family History (possible genetic predisposition)

V. Causes

  1. Medication causes
    1. Anticonvulsants
      1. Carbamazepine (Tegretol)
      2. Phenytoin (Dilantin, occurs in 20-57% of patients)
    2. Calcium Channel Blockers (uncommon)
      1. Amlodipine (Norvasc, occurs in 2-3% of patients)
      2. Nifedipine (Procardia, occurs in 6-15% of patients)
      3. Diltiazem (Cardizem, occurs in 5-20% of patients)
      4. Verapamil (occurs in 5% of patients)
    3. Cyclosporine (Sandimmune)
    4. Erythromycin
    5. Oral Contraceptives
  2. Other causes
    1. Puberty
    2. Pregnancy
    3. Leukemia
    4. Blood dyscrasias

VI. Symptoms

  1. Onset of increased gum tissue starting 1-3 months after causative factors (e.g. medications)

VII. Signs

  1. Gingiva heaped up and partially cover teeth

VIII. Management

  1. Decrease or eliminate causative medications
    1. Discontinuation of causative medications is preferred (consider alternative medications)
    2. Reduce causative medication doses to the lowest effective dose
  2. Dental hygiene to reduce Plaque formation
    1. Twice daily brusing with fluoride toothpaste
    2. Dental flossing
    3. Increased dental office cleaning frequency
    4. Chlorhexidine gluconate (peridex) rinses (as directed by Dentistry)
      1. Risk of Oral Hyperpigmentation
  3. Refractory cases (>3 months)
    1. Open flap Debridement of teeth (Gingiva reflected away from teeth for cleaning)
    2. Excision of excess gum tissue (laser, Electrosurgery, scalpel)

IX. Prognosis

  1. Gingival size typically decreases within 6-12 months of stopping causative medications

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Related Studies

Ontology: Gingival Hyperplasia (C0017566)

Definition (MSH) Non-inflammatory enlargement of the gingivae produced by factors other than local irritation. It is characteristically due to an increase in the number of cells. (From Jablonski's Dictionary of Dentistry, 1992, p400)
Definition (CSP) abnormal multiplication of otherwise normal gingival cells, leading to tissue enlargement.
Concepts Pathologic Function (T046)
MSH D005885
SnomedCT 441798003, 54711002, 196377003, 196375006, 281051000009101
English Gingival Hyperplasias, Hyperplasia, Gingival, Hyperplasias, Gingival, GUM HYPERPLASIA, gingiva hyperplasia, Hyperplasia of gingivae, Gum hyperplasia, Hyperplasia gum, Hyperplasia of gingiva (disorder), Hyperplasia of gingiva, Gingival Hyperplasia [Disease/Finding], enlargement gingival, gingival enlargement, hyperplasia gingival, gingival hyperplasia, gum hyperplasia, Gingival Hyperplasia, Gingival hyperplasia (disorder), Gingival hyperplasia, gingiva; hyperplasia, gum; hyperplasia, hyperplasia; gingiva, hyperplasia; gum, thickening; gingival
Portuguese HIPERPLASIA GENGIVAL, Hiperplasia gengival, Hiperplasia Gengival
Spanish HIPERPLASIA GINGIVAL, Hiperplasia de encías, Hiperplasia de encias, hiperplasia de encías (trastorno), hiperplasia gingival, hiperplasia de encías, Hiperplasia gingival, Hiperplasia Gingival
Dutch hyperplasie tandvlees, tandvleeshyperplasie, gingiva; hyperplasie, hyperplasie; gingiva, hyperplasie; tandvlees, tandvlees; hyperplasie, verdikking; tandvlees, gingiva-hyperplasie, Gingivahyperplasie, Hyperplasie, gingiva-, Tandvleesverdikking
German Hyperplasie des Zahnfleischs, ZAHNFLEISCHHYPERPLASIE, Gingivahyperplasie, Zahnfleischhyperplasie
Japanese 歯肉増殖, 歯肉増生, シニクゾウセイ, シニクゾウショク
Swedish Tandköttshyperplasi
Finnish Ienhyperplasia
French HYPERPLASIE GINGIVALE, Hyperplasie gingivale, Hyperplasie de la gencive
Czech Hyperplazie dásně, Hyperplazie gingivy, dásně - hyperplazie, hyperplazie gingivy, hyperplazie dásní
Polish Rozrost dziąseł
Hungarian Fogíny hyperplasia, Fogíny hyperplasiája, Hyperplasia fogíny
Norwegian Gingival hyperplasi, Tannkjøtthyperplasi
Italian Iperplasia gengivale

Ontology: Gingival Hypertrophy (C0017567)

Definition (MSH) Abnormal enlargement or overgrowth of the gingivae brought about by enlargement of existing cells.
Concepts Disease or Syndrome (T047)
MSH D005886
SnomedCT 441787004, 54711002
English Gingival Hypertrophies, Hypertrophies, Gingival, Hypertrophy, Gingival, GINGIVA HYPERTROPHIA, GINGIVAL HYPERTROPHY, GUM HYPERTROPHY, Hypertrophy of gums, Hypertrophy of gingivae, hypertrophy of gingiva, hypertrophy of gingiva (physical finding), Gingiva hypertrophia, Gingival hypertrophy, Hypertrophy gingival, Gum hypertrophy, Hypertrophy of gingiva, Hypertrophy of gingiva (disorder), Gingival Hypertrophy, Gingival Hypertrophy [Disease/Finding], gingival hypertrophy, gums hypertrophied, gum; hypertrophy, gum; mucous membrane, hypertrophy, hypertrophy; gum, hypertrophy; mucous membrane gum, mucous membrane; gum, hypertrophy, Gingival hypertrophy, NOS, gum; hypertrophy mucous membrane, mucous membrane; hypertrophy gum
French HYPERTROPHIE GINGIVALE, Hypertrophie gingivale, Hypertrophie de la gencive, Hypertrophie des gencives
Portuguese HIPERTROFIA GENGIVAL, HIPERTROFIA DA GENGIVA, Hipertrofia gengival, Hipertrofia Gengival
Spanish HIPERTROFIA GINGIVAL, Hipertrofia de encías, GINGIVAL, HIPERPLASIA, GINGIVAL, HIPERTROFIA, hipertrofia de encías (trastorno), hipertrofia de encías, hipertrofia gingival, Hipertrofia gingival, Hipertrofia Gingival
German GINGIVAHYPERTROPHIE, Hypertrophie der Gingiva, GAUMENHYPERTROPHIE, ZAHNFLEISCHHYPERTROPHIE, Gingivahypertrophie, Zahnfleischhypertrophie
Dutch tandvleeshypertrofie, hypertrofie tandvlees, gingiva-hypertrofie, hypertrofie; slijmvlies tandvlees, hypertrofie; tandvlees, slijmvlies; tandvlees, hypertrofie, tandvlees; hypertrofie, tandvlees; slijmvlieshypertrofie, gingivale hypertrofie, slijmvlies; hypertrofie tandvlees, tandvlees; hypertrofie slijmvlies, Gingivahypertrofie, Hypertrofie, gingiva-
Japanese 歯肉肥厚, 歯肉肥大, 歯肉肥大症, シニクヒダイ, シニクヒダイショウ, シニクヒコウ
Swedish Tandköttsförstoring
Czech dásně - hypertrofie, Hypertrofie gingivy, Hypertrofie dásně
Finnish Ienhypertrofia
Polish Przerost dziąseł
Hungarian Gingiva hypertrophia, Fogíny hypertrophia, Fogíny hypertrophiája, Fogíny-hypertrophia
Norwegian Gingival hypertrofi, Tannkjøtthypertrofi
Italian Ipertrofia gengivale