Desquamative Gingivitis: Symptoms, Causes, and Treatment

Desquamative Gingivitis

Question 1. Describe the etiology, clinical features and management of chronic desquamative gingivitis.
Answer.

Desquamative gingivitis was not a specific disease entity, but a gingival response associated with variety of conditions.

Dermatological diseases such as lichen planus, mucus membrane pemphigoid or pemphigus.
Infections, i.e. tuberculosis, chronic candidiasis and histoplasmosis.
Endocrine imbalance, chronic imbalance and drug reaction.
Abnormal response to irritation and idiopathic causes.
Desquamative Gingivitis can be caused by chemical burns.

“Understanding the role of autoimmune diseases in desquamative gingivitis”

Desquamative Gingivitis is more prevalent in women and occurs after age of 40 years.
Gingiva becomes bright red, edematous and desquamation of surface epithelium of attached gingiva is also seen.
It occurs in three form:
Mild form: There is diffuse erythema of marginal, interdental and attached gingiva. It is painless and occurs most frequently in females between 17 to 23 years of age.

“Case studies on outcomes of desquamative gingivitis therapies”

Moderate form: There is patchy distribution of bright red and gray areas involving marginal and attached gingiva.
- Surface is smooth and shiny, normal resilient gingiva become soft edematous and massaging of gingiva results in peeling of epithelium.
- Patient complains of burning sensation and labial surface is involved.
Severe form: It is characterized by scattered irregularly shaped areas in which gingiva is denuded and strikingly red in appearance.
- Gingiva seems to be speckled and surface epithelium seems shredded friable and can be peeled of in small patches this is known as Nikolsky’s sign
- The mucous membrane other than gingiva is shiny and smooth and may present fisuring in cheek, ill line of occlusion.
- The condition is painful
- There is constant dry, burning, sensation throughout oral cavity.

“Importance of studying desquamative gingivitis for dental professionals”

Management consists of complete history of uncover possible coexistent extraoral cause
It is divided into two parts:

“Signs of desquamative gingivitis in early stages”

Oral hygiene instruction (toothbrush).
Oxidizing mouthwashes, i.e. 3% diluted hydrogen peroxide.
Topical corticosteroid ointments or cream like triamcinolone 0.1%, flurocinonide 0.05%.

“Common challenges in diagnosing desquamative gingivitis”

Desquamative Gingivitis Clinical Management Algorithm

“Role of systemic medications in managing autoimmune gingivitis”

Chronic Desquamative Gingivitis Systemic Treatment

Systemic corticosteroids in moderate doses.
Prednisolone can be used daily or at alternate days at dose of 30 to 40 mg and reduced to daily maintenance dosage of 5 or 10 mg.