Thursday, November 13, 2014

Gingival Hyperplasia

What is gingival hyperplasia?
Gingival hyperplasia is an increase in the size of the gum tissues caused by an increase in the number and normal arrangement of the cells. It is characterized by inflammation of the soft tissues surrounding the teeth. The gum tissues will appear shiny and swollen and dark red to bluish purple in color.

How can I get it?
The predisposing factors in this inflammation can include but are not limited to systemic factors (diabetes mellitus), antiepileptic medications (such as Dilantin, Mysoline, and Depakene), immunosuppressant drugs (cyclosporine), calcium channel blockers (Procardia, Calan, Cardizem, and Bayotensin), select other medications, hormonal changes associated with pregnancy, oral contraceptives, or the types of hormonal changes younger teenagers experience during puberty. We commonly see hyperplasia associated with pregnancy, oral contraception, and puberty.

These conditions do not necessarily cause the gums to become inflamed or enlarged, but rather in the presence of only slight amounts of plaque and/or calculus, the response of the gum tissues can be out of the ordinary. Hyperplasic gingivitis can also occur just because of a large presence of bacterial plaque without any of these factors being present.

If you have any of these predisposing factors or take certain drugs, there is a potential for gingival hyperplasia. Unfortunately, gum disease does not hurt until it is too late. If you have gingival hyperplasia, and if you are lucky, you will probably notice that your gums bleed when you brush and floss. Bleeding is always a sign of disease or infection.

Elimination and/or Prevention
To eliminate or prevent these problems, your oral self-care must be thorough. You must brush and floss and do whatever other oral self-care procedures you have been instructed to do every day. This may clear up the problem entirely. If not, you will need to adjust the interval between recare appointments with the dental hygienist. A time frame of 2, 3, or 4 months between cleanings, depending on the severity of the problem, will be more appropriate for prevention of hyperplasia. This will be necessary for as long as the predisposing factors exist. 
  • If medication is the factor, you will have to see the hygienist at the interval recommended. 
  • If you are pregnant, gingival hyperplasia could persist until the hormonal changes associated with pregnancy revert back to normal. Until then, you need to schedule your oral recare appointments with the dental hygienist as recommended. Similarly, if you take oral contraceptives and notice signs of recurring gum infections (bleeding when brushing and flossing), assuming that your oral self-care is thorough, a more regular recare schedule may be necessary.
  • Gingival hyperplasia in young teens is generally seen where oral self-care is not adequate. A 3-month interval is best in this circumstance. Some teenagers have inadequate oral self-care habits. Junk food and sugar drinks (even juice) coupled with almost nonexistent brushing and flossing cause serious gum disease, bad breath, and decay. Generally, the hormonal change stabilizes and the acute problem resolves.
These recommendations are designed to prevent gum problems. Prevention is better and much less expensive than any cure. If you have dental insurance, it will probably not cover the additional necessary dental treatment. While you do need them to maintain your oral health, these situations are not considered unusual by the carrier and are not generally covered procedures.

If you have any questions about gingival hyperplasia, please feel free to ask us!