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Gingival enlargement among the paediatric population: an overview and case report Sabrina Bhandal Sarah McKaig David McGoldrick Dental Update 2024 50:3, 707-709.
Patients often present with complaints of ‘bleeding and inflamed gums’, which is most frequently indicative of plaque-induced gingivitis. However, bleeding and gingival enlargement can be associated with local and systemic factors and, in some cases, be indicative of malignancy. An 18-month-old boy attended an emergency department with a 4-day history of unexplained bleeding from the gingivae. Intra-oral examination, revealed generalized enlargement of the maxillary gingivae. The gingivae were pink with loss of stippling and a spongy appearance. Following blood tests, the child was diagnosed with acute myeloid leukaemia (AML).
CPD/Clinical Relevance: An awareness of acute leukaemia is important as oral lesions can be the earliest clinical feature and dentists may be the first to see a patient.
Article
Complaints of ‘bleeding and inflamed gums’ are a common problem encountered in general dental practice, and are most frequently indicative of plaque-induced gingivitis. However, bleeding and gingival enlargement can be associated with local and systemic factors, and in some cases be indicative of malignancy. This article explores gingival enlargement in the paediatric population and gives an overview of the range of gingival conditions that present within this population. We also present a case of an 18-month-old child who presented with gingival enlargement and bleeding through the emergency department.
Children's gingivae typically appear reddish in colour with rounded and rolled gingival margins (Figure 1).1 In a healthy state, the gingival margin is several millimetres coronal to the cemento-enamel junction. The gingival sulcus may be 0.5–3 mm deep on a fully erupted tooth.2 Contact points between primary teeth are not as tight as those between the permanent dentition, which can allow for an increased area of potential bacterial growth.1 Diseases and disorders affecting the gingivae can be divided into those that are related to local inflammatory factors and those that are related to systemic factors (Table 1).
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