Gingival enlargement, also known as gingival hyperplasia, refers to an increase in the size of the gum tissue around the teeth. While often a cosmetic concern, it can also indicate underlying health issues. This common dental condition is often treatable.
Common Causes of Gum Enlargement
A frequent reason for gum enlargement is inflammation, primarily due to poor oral hygiene. When plaque, a sticky film of bacteria and food debris, accumulates on teeth, it can lead to gingivitis, an inflammation of the gums. This inflammation causes the gum tissues to swell, becoming tender, red, and prone to bleeding. If left unaddressed, gingivitis can progress to periodontitis, a more severe form of gum disease.
Certain medications can also induce gingival enlargement as a side effect, even with good oral hygiene. These include anticonvulsants like phenytoin (for seizures), immunosuppressants such as cyclosporine (for organ transplant recipients), and calcium channel blockers like nifedipine (for high blood pressure and chest pain). This medication-induced enlargement occurs because these drugs can alter the metabolism of gum tissue cells, leading to excessive growth.
Systemic conditions and hormonal changes are another category of causes for enlarged gums. Hormonal fluctuations during puberty and pregnancy can make gums more susceptible to inflammation, leading to swelling and tenderness. Conditions like leukemia can also manifest as generalized gum enlargement. Scurvy, a severe vitamin C deficiency, can cause gums to become swollen, bluish-red, and easily bleeding. Rare genetic conditions like hereditary gingival fibromatosis can also result in a slow, progressive overgrowth of gum tissue, often presenting in childhood.
Identifying Symptoms and Seeking Care
Beyond the noticeable increase in gum size, several other symptoms can signal gingival enlargement or an underlying problem. These include redness, tenderness, or bleeding of the gums, particularly when brushing or flossing. You might also observe changes in gum texture, such as puffiness or a firm, fibrous appearance. In some cases, enlarged gums can make teeth appear shorter or even cover parts of them.
Difficulty cleaning teeth due to overgrown gum tissue is another common sign, which can further exacerbate plaque buildup and inflammation. Persistent bad breath or discomfort in the mouth may also accompany gum enlargement. If you notice any of these symptoms, it is important to consult a dental professional. A dentist can accurately diagnose the cause of the enlargement and recommend an appropriate course of action, as treatment depends on identifying the specific reason behind the gum overgrowth.
Approaches to Treatment and Management
Addressing gingival enlargement often begins with improved oral hygiene, especially for cases linked to inflammation. Regular and thorough brushing, daily flossing, and professional dental cleanings, including scaling and root planing, help remove plaque and tartar buildup. This can significantly reduce inflammation and, in many cases, lead to a resolution of the enlargement.
For medication-induced enlargement, managing the condition typically involves a discussion with your doctor about the medications you are taking. It may be possible to adjust the dosage or switch to an alternative medication that does not cause this side effect. However, any changes to prescribed medications must be made under the guidance of a physician.
When non-surgical methods are insufficient, particularly for severe or persistent cases, surgical interventions may be recommended. Procedures like gingivectomy involve the precise removal of excess gum tissue to restore a healthy gum contour and improve aesthetics. Flap surgery, another surgical option, may be used for deeper cleaning and to reshape gum tissue, especially when there are deep pockets between the gums and teeth.
Managing underlying systemic issues is important for certain types of gum enlargement. For instance, if the enlargement is related to a hormonal condition, addressing those hormonal imbalances can contribute to the resolution of gum overgrowth. The specific treatment approach for enlarged gums is always tailored to the individual’s condition, taking into account the cause and severity of the enlargement.