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.
Desquamative Gingivitis Etiology
- 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.
Chronic Desquamative Gingivitis Clinical Features
- 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.
- 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.
Read And Learn More: Periodontics Question And Answers
Chronic Desquamative Gingivitis Management
- Management consists of complete history of uncover possible coexistent extraoral cause
- It is divided into two parts:
Chronic Desquamative Gingivitis Local Treatment
- Oral hygiene instruction (toothbrush).
- Oxidizing mouthwashes, i.e. 3% diluted hydrogen peroxide.
- Topical corticosteroid ointments or cream like triamcinolone 0.1%, flurocinonide 0.05%.
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.
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