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Gingival Hyperplasia in Children

By Daniel Zimmermann

Gingeval tissue surrounds the roots of teeth. On rare occasions, this tissue becomes abnormally large, a condition known as gingival hyperplasia. The enlargement does not result from cancerous malignancy, but from excessive growth of normal tissue. Children may suffer this abnormality for a variety of reasons.


Gingival hyperplasia involves the excessive growth of either the epithelial tissue that lies on the surface of the gums or the connective tissue that lies beneath the surface. Prickle cells proliferate, and rete ridges become abnormally long. Prickle cells are rough-looking cells that normally form an orderly layer in the epidermis. Rete ridges are epidermal cells that jut into the dermal layer beneath it. Such irregularities in the gum tissue provide havens for bacterial growth, and complications may result, such as the inflammation of the gums known as gingivitis. Enlargement of gingival tissue also causes emotional distress and adversely affects facial appearance of people of all ages. Young children may experience difficulties when new teeth breaking through the gums.

Congenital Gingival Hyperplasia

In some cases, children suffer congenital gingival hyperplasia. This means that the condition exists when the child is born. The condition is often associated with some other congenital abnormality, such as hypertrichosis, a condition in which body hair grows in abundance.

Diseased-Induced Gingival Hyperplasia

People of all ages, including children, may suffer gingival hyperplasia as a result of some systemic diseases. The “European Journal of Dentistry” reports a case in which gingival hyperplasia proved to be a symptom of a cancerous condition called acute myeloblastic leukemia. Since excessive gingival growth is an early symptom of the disease, its presence in the patient gave timely warning to the serious underlying disease. Prompt treatment of the leukemia resulted in an amelioration of the gingival disorder. Other similar forms of leukemia also cause gingival hyperplasia, such as myelomonocytic leukemia.

Drug-Induced Gingival Hyperplasia

Gingival hyperplasia may result from the use of prescription medicines such as cyclosporine, a drug that depresses the immune system, and amlodipine, a calcium-blocking drug given to patients suffering hypertension. Phenytoin, a drug used to treat epilepsy, causes an especially large number of gingival hyperplasia cases. Children suffer this side effect more frequently than adults, and boys suffer more frequently than girls. Discontinuance of phenytoin reverses the condition but does not completely cure it.

Folic Acid

Folic acid reduces the incidence of phenytoin-induced gingival hyperplasia. R. Arya and colleagues conducted a test on 100 children who were receiving phenytoin treatment for epilepsy. Sixty-two received folic acid while receiving the treatment. Fifty-eight received a placebo. Eighty-eight percent of the children who received the placebo contracted gingival hyperplasia, while only 21 percent of children receiving folic acid suffered the disorder, according to the journal “Neurology.”

Proper Oral Hygiene

Proper oral care may minimize a child’s chances of suffering from gingival hyperplasia. Brushing the teeth regularly and the proper application of dental floss promotes a healthful oral environment in which abnormal conditions can develop only with difficulty.

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