Desquamative gingivitis

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Desquamative gingivitis - Wikipedia

From Wikipedia, the free encyclopedia

Desquamative gingivitis
Other names	DG
Specialty	Periodontology

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]

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]

Oral lichen planus^[1]
Cicatricial pemphigoid^[1] or less commonly bullous pemphigoid^[1]
Pemphigus vulgaris^[1]
Linear immunoglobulin A disease^[1]
Dermatitis herpetiformis^[1]
Lupus erythematosus^[1]
Chronic ulcerative stomatitis^[1]
Chronic bacterial, fungal, and viral infections^[1]
Reactions to medications, mouthwashes, and chewing gum^[1]

Rare causes include:

Crohn's disease^[1]
Sarcoidosis^[1]
Leukemia^[1]
factitious (self inflicted) lesions^[1]
Squamous cell carcinoma (can be mistaken for desquamative gingivitis)^[1]

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

^ ^a ^b ^c ^d ^e ^f ^g ^h ⁱ ^j ^k ^l ^m ⁿ ^o ^p ^q ^r ^s ^t ^u Newman, Michael G.; Takei, Henry H.; Carranza, Fermín A., eds. (2012). Carranza's clinical periodontology (11th ed.). St. Louis, Mo: Elsevier/Saunders. pp. 111–126. ISBN 978-1-4377-0416-7.
^ 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.
^ ^a ^b Odell, E. W., ed. (2010). Clinical problem solving in dentistry. Clinical problem solving in dentistry series (3rd ed.). Edinburgh ; New York: Churchill Livingstone. p. 192. ISBN 978-0-443-06784-6. OCLC 427608817.
^ Welbury R; Duggal M; Hosey MT (2012). Welbury, Richard; Duggal, Monty S.; Hosey, Marie Thérèse (eds.). Paediatric dentistry (4th ed.). Oxford: Oxford University Press. p. 319. ISBN 978-0-19-957491-9.

External links

Oral and maxillofacial pathology

Lips
Cheilitis Actinic Angular Plasma cell Cleft lip Congenital lip pit Eclabium Herpes labialis Macrocheilia Microcheilia Nasolabial cyst Sun poisoning Trumpeter's wart

Tongue
Ankyloglossia Black hairy tongue Caviar tongue Crenated tongue Cunnilingus tongue Fissured tongue Foliate papillitis Glossitis Geographic tongue Median rhomboid glossitis Transient lingual papillitis Glossoptosis Hypoglossia Lingual thyroid Macroglossia Microglossia Rhabdomyoma

Palate
Bednar's aphthae Cleft palate High-arched palate Palatal cysts of the newborn Inflammatory papillary hyperplasia Stomatitis nicotina Torus palatinus

Oral mucosa – Lining of mouth

Teeth (pulp, dentin, enamel)

Periodontium (gingiva, periodontal ligament, cementum, alveolus) – Gums and tooth-supporting structures

Periapical, mandibular and maxillary hard tissues – Bones of jaws

Temporomandibular joints, muscles of mastication and malocclusions – Jaw joints, chewing muscles and bite abnormalities
Bruxism Condylar resorption Mandibular dislocation Malocclusion Crossbite Open bite Overbite Overeruption Overjet Prognathia Retrognathia Scissor bite Maxillary hypoplasia Temporomandibular joint dysfunction Condylar hypoplasia Condylar hyperplasia

Salivary glands

Stomatognathic system – Teeth, jaws, tongue and associated soft tissues
Bruxism Mouth breathing Sleep apnea Catathrenia Central hypoventilation syndrome Obesity hypoventilation syndrome Obstructive sleep apnea Periodic breathing Snoring

Orofacial soft tissues – Soft tissues around the mouth
Actinomycosis Angioedema Basal cell carcinoma Cutaneous sinus of dental origin Cystic hygroma Gnathophyma Ludwig's angina Macrostomia Melkersson–Rosenthal syndrome Microstomia Noma Oral Crohn's disease Orofacial granulomatosis Perioral dermatitis Pyostomatitis vegetans

Other
Eagle syndrome Hemifacial hypertrophy Facial hemiatrophy Oral manifestations of systemic disease

Dentistry involving supporting structures of teeth (Periodontology)

Anatomy

Disease

Diagnoses	Chronic periodontitis Localized aggressive periodontitis Generalized aggressive periodontitis Periodontitis as a manifestation of systemic disease Periodontosis Necrotizing periodontal diseases Abscesses of the periodontium Combined periodontic-endodontic lesions
Infection	A. actinomycetemcomitans Capnocytophaga sp. F. nucleatum P. gingivalis P. intermedia T. forsythia T. denticola Red complex Entamoeba gingivalis (amoebic) Trichomonas tenax
Other	Calculus Clinical attachment loss Edentulism Fremitus Furcation defect Gingival enlargement Gingival pocket Gingival recession Gingivitis Horizontal bony defect Linear gingival erythema Occlusal trauma Periodontal pocket Periodontal disease Periodontitis Plaque Vertical bony defect
Treatment and prevention	Periodontal examination Ante's law Brushing Bleeding on probing Chlorhexidine gluconate Flossing Hydrogen peroxide Mouthwash Oral hygiene Tetracycline Triclosan Host modulatory therapy

Treatment

Conventional therapy

Surgery

Important personalities

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