When it comes to taking good care of your oral health, an occasional bout of inflammation can throw your hygiene off track. When your gums are sore and swollen, making sure to brush and floss can be hard. Unfortunately, this can start a cycle that leads to more serious dental conditions such as gingival hyperplasia. Here’s what you should know about this condition.

What is gingival hyperplasia?

Gingival hyperplasia is also referred to as gingival overgrowth, gingival enlargement, and hypertrophic gingivitis. Regardless of its name, the definition is the same. An increase of cells (hyperplasia) in the gingival tissue (the gums) produces redness and inflammation.

This occurs most often in the gums of the front teeth but can also be present on the sides of your mouth as well.

What causes gingival hyperplasia?

There are four main causes of gingival hyperplasia, including:

  1. Inflammation caused by poor oral hygiene
  2. Drug-induced gingival hyperplasia
  3. Hereditary gingival fibromatosis
  4. Systemic causes

Inflammation caused by poor oral hygiene

Arguably the most common cause of gingival hyperplasia is poor oral hygiene.

When plaque is not removed from the teeth, it begins to accumulate, irritating the gums and causing inflammation.

Drug-induced gingival hyperplasia

Drug-induced hyperplasia is caused by over 20 different medications in three different classes (see more below). Taking these medications also has as an unfortunate side effect of swelling and inflammation in the gingiva.

In some cases, gingival hyperplasia does not develop when patients are very diligent with their oral hygiene, but this is not always so. For some, even scrupulous care is not enough to prevent gingival hyperplasia.

Hereditary gingival fibromatosis

This condition is rare, hereditary, and usually develops during childhood. Because hereditary gingival fibromatosis is slow-growing, symptoms may not present until adulthood.

In general, gums are not characteristically swollen or tender, but the gingiva overgrows the gums to such a degree that surgical removal may be necessary. This type of hyperplasia is recurrent and may necessitate repeated surgical removals.

Systemic causes

Systemic conditions may also be responsible for the development of gingival hyperplasia. The most common conditions include:

  • Pregnancy
  • Hormonal imbalances
  • Leukemia
  • HIV
  • Diabetes
  • Anemia
  • Crohn’s disease
  • Lymphoma
  • Vitamin deficiencies

As with drug-induced hyperplasia, the chances of developing gingival hyperplasia in concert with one of the above conditions increases with poor oral hygiene.

Less common but still a possible cause, prolonged orthodontic work can also cause gingival hyperplasia.

What medications can cause gingival hyperplasia?

There are over 20 different drugs that can lead to drug-induced gingival hyperplasia. In particular, medications that most often contribute to symptoms include:

  1. Phenytoin
  2. Phenobarbital
  3. Lamotrigine
  4. Vigabatrin
  5. Ethosuximide
  6. Topiramate
  7. Primidone
  8. Nifedipine
  9. Diltiazem
  10. Amlodipine
  11. Felodipine
  12. Verapamil
  13. Cyclosporine A

The medications on this list fall into three classes: anticonvulsants, calcium channel blockers, and immunosuppressants. Many people rely on these medications to treat a variety of conditions, some of which are life-threatening.

Gingival hyperplasia is a common side effect, but there are ways to manage it as discussed later in this post.

What are common gingival hyperplasia symptoms?

Although everyone’s body responds to inflammation differently, there are some common gingival hyperplasia symptoms. These include:

  • Red gums that are tender to the touch
  • Inflammation
  • Pain (to the touch but also when chewing)
  • Bad breath
  • Visible plaque buildup on teeth
  • Gums that stretch over the teeth

Left untreated, the gums can swell to completely cover the teeth. This makes proper dental hygiene difficult and can result in serious issues like periodontal disease and gum abscess. Eventually the pressure of the gums on the teeth may affect tooth