Classification
Plaque-Induced Gingivitis on Intact Periodontium
Most common form; caused by bacterial plaque; fully reversible with treatment
- • Erythema, edema, BOP
- • Normal probing depths (<3mm)
- • No bone loss
- • Reversible after plaque control
Gingivitis Mediated by Systemic/Local Risk Factors
Exaggerated response to plaque due to hormones, medications, systemic disease
- • Disproportionate inflammation for plaque level
- • May include gingival overgrowth
- • Medication review important
- • Plaque control reduces but may not eliminate inflammation without treating systemic factor
Drug-Induced Gingival Overgrowth
Fibrotic gingival enlargement from phenytoin, cyclosporin, or calcium channel blockers
- • Painless, firm nodular gingival enlargement
- • Begins in interdental papillae
- • Worsened by poor plaque control
- • May require gingivectomy if plaque control insufficient
Necrotizing Ulcerative Gingivitis (NUG)
Acute, painful necrosis of interdental papillae; associated with stress, poor nutrition, immunosuppression
- • Punched-out ulceration of papillae
- • Grayish pseudomembrane
- • Fetid odor (halitosis)
- • Bleeding and pain
- • Associated with HIV in Africa