Desquamative gingivitis

Desquamative gingivitis is an erythematous (red), desquamatous (shedding) and ulcerated appearance of the gums.[1] It is a descriptive term and can be caused by several different disorders.[2]

Desquamative gingivitis
Other namesDG
SpecialtyPeriodontology 

Signs and symptoms

Desquamative gingivitis involves lesions of the free and attached gingiva. Unlike plaque-induced inflammation of the gums (normal marginal gingivitis), desquamative gingivitis extends beyond the marginal gingiva, involving the full width of the gingiva and sometimes the alveolar mucosa.[3] The term "full width gingivitis" usually refers to the oral lesions of orofacial granulomatosis however.[4] The color is another dissimilarity between typical marginal gingivitis and desquamative gingivitis, in the latter it is dusky red.[3] Plasma cell gingivitis is another form of gingivitis which affects both the attached and free gingiva.[1]

Cause

Caused by various autoimmune diseases as well as allergies. Erosive lichen planus, mucous membrane pemphigoid, pemphigus vulgaris, erythema exsudativum multiforme and lupus erythematosus.

Diagnosis

Differential diagnosis

Desquamative gingivitis is a descriptive clinical term, not a diagnosis.[1] Dermatologic conditions cause about 75% of cases of desquamative gingivitis, and over 95% of the dermatologic cases are accounted for by either oral lichen planus or cicatricial pemphigoid.[1] The exact cause of desquamative gingivitis cannot be determined about a third of cases.[1]

Rare causes include:

Treatment
  • Improving oral hygiene
  • Minimising irritation of the lesions
  • Specific therapies for the underlying disease (where available)
  • Local or systemic immunosuppressive or dapsone therapy (notably not corticosteroids)

History

This condition was first recognized and reported in 1894, but the term desquamative gingivitis was not coined until 1932.[1]

References
  1. (editors) Newman MG, Takei HH, Klokkevold PR, Carranza FA (2012). Carranza's clinical periodontology (11th ed.). St. Louis, Mo.: Elsevier/Saunders. pp. 111–126. ISBN 978-1-4377-0416-7. {{cite book}}: |last= has generic name (help)CS1 maint: multiple names: authors list (link)
  2. Lo Russo, L; Fedele, S; Guiglia, R; Ciavarella, D; Lo Muzio, L; Gallo, P; Di Liberto, C; Campisi, G (January 2008). "Diagnostic pathways and clinical significance of desquamative gingivitis". Journal of Periodontology. 79 (1): 4–24. doi:10.1902/jop.2008.070231. PMID 18166088.
  3. Odell EW (Editor) (2010). Clinical problem solving in dentistry (3rd ed.). Edinburgh: Churchill Livingstone. p. 192. ISBN 9780443067846. {{cite book}}: |last= has generic name (help)
  4. Welbury R; Duggal M; Hosey MT (2012). Paediatric dentistry (4th ed.). Oxford: Oxford University Press. p. 319. ISBN 978-0199574919.
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