If possible, substitutions are made for the offending drugs. Scrupulous oral hygiene may minimize fibrosis. Localized gingival enlargement often occurs near sites of chronic irritation. Peripheral ossifying fibroma and peripheral giant cell granuloma are less common. The latter often causes resorption of adjacent bone.
Treatment is excision and removal of any local irritants.
Carcinoma may originate in the gingiva and spread to regional lymph nodes. Swelling and food impaction deepen the normal crevice between the gingiva and the teeth so that gingival pockets form. Gingivitis does not occur in edentulous areas. The most common single cause is poor oral hygiene, which allows plaque to accumulate. Other local factors, such as malocclusion, dental calculus, food impaction, faulty dental restorations, and xerostomia play a secondary role.