Unusual Cases of Plasma Cell Gingivitis

A case study caught my eye recently in “Clinical Advances in Periodontics” not because the patient had a common dental problem. Instead, the patient had common causes, with an uncommon diagnosis than what you typically see in these cases.

I found it worthwhile reminder that these cases exist, their common cause? an immune response to an allergen.

Plasma cell gingivitis (PCG) is a rare condition of gingiva marked by diffuse plasma cells into the sub-epithelial gingival tissue. Identified as an allergic reaction to a component of chewing gum, such as cinnamon or mint, it can also be caused by clove, or other herbal products in toothpaste, red peppers, chewing gum of khat leaves.

It has been suggested that PCG might be an immune response to some microorganism or an undetectable hormonal imbalance. PCG is also known as allergic gingivostomatitis, atypicalgingivostomatitis, stomatitis venanta, irritant contact stomatitis, and idiopatich when no allergen is identified.

PCG appears as diffuse reddening and edematous enlargement of the gingiva extending up to the mucugingival junction. In addition to clinical and histopathological examination, PCGmust be differentiated from other lesions through hematologic and serologic testing. Remission of the lesions with removal of the allergen often confirms the diagnosis, although in some extreme cases periodontal surgery may be required.

Characteristic appearance of the gingival enlargement of a patient with PCG.

You can find a case study of the eventual diagnosis and treatment of a patient who developed PCG after a lifetime of using herbal tooth powder here.