Puberty-associated gingivitis
Puberty-associated gingivitis
Gingivitis is commonly observed in pre-teens and young teenagers where the increased inflammatory response to plaque is thought to be aggravated by the hormonal changes associated with puberty. The presentation may vary between individuals and in some cases marked gingival enlargement can occur.
Ensure you have an up-to-date medical history for all patients.
Provide personalised oral hygiene advice and instruction to assist and encourage the patient to improve their oral hygiene skills as well as their understanding of the value of good self-care routines (see Oral hygiene).
Where applicable, give information regarding other personal risk factors and modifying them, for example, advice on smoking cessation and diabetes control (see Smoking cessation and Control of diabetes).
Remove factors that impede effective plaque control, such as calculus, using an appropriate method.
Ensure that other local plaque retentive factors are corrected - for example, remove overhanging restorations or alter denture design. Ensure patients are able to clean effectively around fixed orthodontic appliances.
Where puberty-related gingival enlargement hinders adequate oral hygiene or interferes with the normal function of the oral cavity, consider referring to a consultant in paediatric dentistry, consultant in restorative dentistry or specialist periodontist.
Re-assess at a future visit to determine whether the gingivitis has resolved.
In cases of unexplained gingivitis which does not respond to treatment as expected, or the extent of the condition is inconsistent with the level of oral hygiene observed, consider urgent referral to an oral medicine specialist or specialist periodontist.