Regardless of the cause of gingival enlargement, improved oral hygiene is recommended to ensure that irritation is removed. Lesions of the bone or the dental tissue beneath the gums can also lead to gingival enlargements that are considered false gingival enlargements. Diseases that lead to gingival enlargement include leukemia, granulomatous diseases, benign neoplasms, and malignant neoplasms these neoplasms are associated with neoplastic gingival enlargement. Conditions related to gingival enlargement include pregnancy, puberty, vitamin C deficiency, and some nonspecific conditions. Systemic diseases and conditions may develop gingival enlargement as a characteristic. In most cases, when the drug is discontinued, the enlargement resolves. Drug-induced gingival enlargement is believed to be associated with a genetic predisposition in certain patients, and it is unclear whether underlying inflammation is an integral part of drug-induced gingival enlargement. About half of all cases of drug-induced gingival enlargement are related to the anticonvulsant phenytoin 30% are related to cyclosporins, and the remainder are attributed to calcium channel blockers. These drug classes are anticonvulsants, calcium channel blockers, and an immunosuppressant called cyclosporine. Inflammatory gingival enlargement may also be a result of irritation due to dehydration in mouth breathers, though the direct causes of this type of gingival enlargement are unclear.ĭrug-induced gingival enlargement usually results from one of three different classes of drugs. The primary risk factor is poor oral hygiene, though inflammatory gingival enlargement can also be a result of physical irritation of the tissue by dental appliances or restorations. The most common treatment for inflammatory gingival enlargement is periodontal treatment, which usually consists of scaling and root planing. This exposure causes swelling, infection, and discoloration of the gingiva. The most common cause of gingival enlargement is chronic inflammatory enlargement due to extended exposure to bacterial plaque. The only way to identify these conditions is through a microscopic evaluation of the tissue, which is not, traditionally, a part of diagnosis and which is also not necessary for accurate classification and treatment. Hyperplasia is characterized by an increase in the number of cells, while hypertrophy is characterized by the increased size of individual cells. While gingival enlargement may, at times, be a manifestation of hypertrophy or hyperplasia, these are strict diagnoses related to the cellular anatomy of tissues and require microscopic analysis of tissue samples for definitive diagnosis. Historically, gingival enlargement has been referred to as gingival hyperplasia and gingival hypertrophy. These are inflammatory enlargement, drug-induced enlargement, enlargement associated with systemic diseases of conditions, neoplastic enlargement, and false enlargement. There are five general groups, classified by cause. Gingival enlargement can be caused by many different factors, and treatment depends on the cause, though hygienic measures are recommended in all cases of gingival enlargement. Gingival enlargement is a common characteristic of gingival disease and is manifested as an increase in the size of the gums.