Desquamative gingivitis is a potentially serious form of gum disease. Problems occur when gum layers begin to separate from each other, causing inflammation and creating space for bacteria to thrive. The condition is most commonly seen in middle-aged and elderly women, and it often causes pain, sensitivity, and swelling that can make speaking and eating difficult. Most cases of desquamative gingivitis can be treated with consistent hygiene practices and regular care at a dentist's office or clinic.
The exact cause of desquamative gingivitis is not well understood, but it appears that several different factors may be involved. Unlike most forms of gingivitis, the desquamative variety does not seem to be a result of especially poor oral hygiene. Some people develop the problem despite proper brushing, flossing, and general mouth care. An allergy-related condition called lichen planus can cause skin rashes, eye problems, and oral lesions on the gums that may develop into desquamative gingivitis. Genetic and congenital conditions that affect the immune system also seem to precede gum problems in some individuals.
Early symptoms of desquamative gingivitis may include mild swelling and redness in the upper or lower gums. Over time, swelling worsens and the gums start to bleed after brushing. They can become fiery red and very tender as tissue layers actually begin to separate. A person may also notice the appearance of small white patches in the middle of the gums that flake off easily when rubbed or brushed. Once bacteria bury within gum tissue, constant pain, bad breath, and difficulties talking and swallowing become the prominent symptoms.
In most cases, dentists can easily diagnose desquamative gingivitis by simply examining the gums. Mucus and gum tissue samples are occasionally collected to check for the presence of specific bacteria or fungi. In addition, a dentist usually decides to take x-rays of the mouth to make sure abscesses or other tooth root problems have not developed.
The mainstay of treatment for desquamative gingivitis is proper oral hygiene. Patients are instructed to brush, floss, and rinse daily as well as set regular appointment for professional dental cleanings. When specific bacteria are discovered, topical or oral antibiotics may be prescribed to be taken for two to four weeks. If swelling and inflammation are severe upon examination, the dentist may decide to inject a corticosteroid directly into the gum wall. Corticosteroids temporarily block the immune system's response to bacteria, which prevents further irritation.