Plasma Cell Ginigivitis

What is plasma cell gingivitis?

Plasma cell gingivitis is a condition that often consists of a mild enlargement of the gums at the marginal areas which may extend to the gums attached over the alveolar bone. The condition is also known as atypical gingivitis, plasma cell gingivostomatitis and plasma cell granuloma.
The condition was first reported in 1970s after an chewing gum ingredient caused allergic reaction leading to inflammation of the gums.

Plasma Cell Gingivitis Symptoms

Patients suffering from plasma cell gingivitis experience a rapid onset of soreness of mouth, which exaggerates on usage of tooth pastes or spicy foods. The entire area of gum margins and attached gums becomes bright red in color. A diffuse enlargement which demolishes the stippling present over the gums is also accompanied with the erythema. The affected areas of gums in plasma cell gingivitis become more friable in nature. The lesion tends to bleed easily and may shows formation of granule like structures over the margins of the gums.

The enlargement and erythema may extend to the other parts of the oral cavity such as the palate. The disease may be associated with inflammation of the tongue (glossitis) and inflammation of the lips (cheilitis).The lips become dry, atrophic and fissured in consistency. The tongue shows formations of furrows and crenations. The tongue may also become red in color and enlarged in size.

In few instances the plasma cell gingivitis can cause marked gingival enlargements. The gingival enlargements can further lead to progressive periodontal diseases such as rapidly progressing periodontis.

Causes of Plasma Cell Gingivitis

Plasma cells gingivitis is believed to be an allergic reaction in origin. It is a hyper-sensitivity type of allergic reaction which is localized in nature. The gum tissue shows an accumulation of inflammatory cells and hyperplasia at the outer layers of the tissue; which leads to the enlargement of the gums. The inflammatory cells present are predominantly plasma cells. It also causes dilatation of the vessels underlying the epithelial cells of the gum margins.

Occurrence of plasma cell gingivitis is generally related to usage of the products such as chewing gums, tooth pastes or dietary components. The condition develops as soon as the individual comes in contact with an offending allergens present in the specific products.
The reported allergens that can cause plasma cell gingivitis include certain brand of herbal tooth pastes, a specific type of mint candy and pepper used for cooking.

Plasma Cell Gingivitis Treatment

Patients suffering from plasma cell gingivitis should record their dietary history in order to narrow down the allergen involved. It is advisable that not only dietary products but products use for cosmetic or hygiene maintenance purposes in and around the oral cavity should be noted. This may include foods, tooth pastes, creams, ointments mouthwash, tobaaco candy, chewing gum and medications. Extensive allergy testing can be undertaken if the other methods to establish the allergen fails.

If the cause of the allergy is not determined patients can be treated using a topical or systemic immunosuppressant medication to reduce the hypersensitivity reaction. Betamethasone mouth rinses, flucinonide gel, topical triamcinolone and fusidic acid ointments are used for relieving the discomfort.

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