eMedicine Specialties > Emergency Medicine > Ear, Nose, & Throat

Gingivitis: Differential Diagnoses & Workup

Author: James M Stephen, MD, FAAEM, FACEP, Assistant Professor, Tufts University School of Medicine; Attending Physician and Director of Medical Informatics, Department of Emergency Medicine, Associate Director, Kiwanis Pediatric Trauma Service, Tufts Medical Center
Contributor Information and Disclosures

Updated: Oct 15, 2008

Differential Diagnoses

Adrenal Insufficiency and Adrenal Crisis
HIV Infection and AIDS

Other Problems to Be Considered

Gingivitis, desquamative
Gingivitis, diabetes mellitus
Gingivitis, phenytoin
Gingivitis, pregnancy
Glossitis
Noma (cancrum oris)
Pericoronitis
Periodontitis
Vincent angina (trench mouth)

Workup

Laboratory Studies

  • Laboratory testing is not helpful in diagnosing gingivitis.
  • If systemic disease or toxin exposure is suspected, laboratory tests should be requested.
  • A smear to identify the causative agent may be helpful.

Imaging Studies

  • Imaging studies are not indicated.

More on Gingivitis

Overview: Gingivitis
Differential Diagnoses & Workup: Gingivitis
Treatment & Medication: Gingivitis
Follow-up: Gingivitis
Multimedia: Gingivitis
References

References

  1. Idigbe EO, Enwonwu CO, Falkler WA, et al. Living conditions of children at risk for noma: Nigerian experience. Oral Dis. Apr 1999;5(2):156-62. [Medline].

  2. Dorfer CE, Becher H, Ziegler CM, et al. The association of gingivitis and periodontitis with ischemic stroke. J Clin Periodontol. May 2004;31(5):396-401. [Medline].

  3. Hujoel PP, Drangsholt M, Spiekerman C, DeRouen TA. Periodontal disease and coronary heart disease risk. JAMA. Sep 20 2000;284(11):1406-10. [Medline].

  4. Wu T, Trevisan M, Genco RJ, et al. Periodontal disease and risk of cerebrovascular disease: the first national health and nutrition examination survey and its follow-up study. Arch Intern Med. Oct 9 2000;160(18):2749-55. [Medline].

  5. Bobetsis YA, Barros SP, Offenbacher S. Exploring the relationship between periodontal disease and pregnancy complications. J Am Dent Assoc. Oct 2006;137 Suppl 2:7S-13S. [Medline].

  6. Mealey BL. Periodontal disease and diabetes: A two-way street. J Am Dent Assoc. Oct 2006;137 Suppl 2:26S-31S. [Medline].

  7. Perez A, Wagner AM, Carreras G, et al. Prevalence and phenotypic distribution of dyslipidemia in type 1 diabetes mellitus: effect of glycemic control. Arch Intern Med. Oct 9 2000;160(18):2756-62. [Medline].

  8. Lorenz K, Bruhn G, Heumann C, et al. Effect of two new chlorhexidine mouthrinses on the development of dental plaque, gingivitis, and discolouration. A randomized, investigator-blind, placebo-controlled, 3-week experimental gingivitis study. J Clin Periodontol. Aug 2006;33(8):561-7. [Medline].

  9. Zimmer S, Kolbe C, Kaiser G, et al. Clinical efficacy of flossing versus use of antimicrobial rinses. J Periodontol. Aug 2006;77(8):1380-5. [Medline].

  10. Triratana T, Rustogi KN, Volpe AR, et al. Clinical effect of a new liquid dentifrice containing triclosan/copolymer on existing plaque and gingivitis. J Am Dent Assoc. Feb 2002;133(2):219-25. [Medline].

  11. Taiyeb Ali TB, Waite IM. The effect of systemic ibuprofen on gingival inflammation in humans. J Clin Periodontol. Nov 1993;20(10):723-8. [Medline].

  12. Johnson RH, Armitage GC, Francisco C, Page RC. Assessment of the efficacy of a nonsteroidal anti-inflammatory drug, Naprosyn, in the treatment of gingivitis. J Periodontal Res. Jul 1990;25(4):230-5. [Medline].

  13. Cronin M, Dembling W, Warren PR, King DW. A 3-month clinical investigation comparing the safety and efficacy of a novel electric toothbrush (Braun Oral-B 3D Plaque Remover) with a manual toothbrush. Am J Dent. Sep 1998;11(Spec No):S17-21. [Medline].

  14. Forrest JL, Miller SA. Manual versus powered toothbrushes: a summary of the Cochrane Oral Health Group's Systematic Review. Part II. J Dent Hyg. Spring 2004;78(2):349-54. [Medline].

  15. Bahekar AA, Singh S, Saha S, Molnar J, Arora R. The prevalence and incidence of coronary heart disease is significantly increased in periodontitis: a meta-analysis. Am Heart J. Nov 2007;154(5):830-7. [Medline].

  16. Briggs GG, Freeman RK, Yaffe SJ. Drugs in Pregnancy and Lactation. 6th ed. Lippincott Williams & Wilkins; 2001.

  17. Estafan D, Gultz J, Kaim JM, et al. Clinical efficacy of an herbal toothpaste. J Clin Dent. 1998;9(2):31-3. [Medline].

  18. Falkler WA Jr, Enwonwu CO, Idigbe EO. Microbiological understandings and mysteries of noma (cancrum oris). Oral Dis. Apr 1999;5(2):150-5. [Medline].

  19. Gaspar L, Suri C, Toth BZ, et al. [Experience with clindamycin in stomatologic diseases]. Fogorv Sz. Aug 1999;92(8):251-8. [Medline].

  20. Gehlen I, Netuschil L, Georg T, et al. The influence of a 0.2% chlorhexidine mouthrinse on plaque regrowth in orthodontic patients. A randomized prospective study. Part II: Bacteriological parameters. J Orofac Orthop. 2000;61(2):138-48. [Medline].

  21. Greenspan JS. Oral manifestation of disease. In: Fauci, et al, eds. Harrison's Principles of Internal Medicine. 13th ed. McGraw Hill; 1994:199-200.

  22. Guggenheimer J, Eghtesad B, Close JM, Shay C, Fung JJ. Dental health status of liver transplant candidates. Liver Transpl. Feb 2007;13(2):280-6. [Medline].

  23. Howell RB, Jandinski JJ, Palumbo P, et al. Oral soft tissue manifestations and CD4 lymphocyte counts in HIV-infected children. Pediatr Dent. Mar-Apr 1996;18(2):117-20. [Medline].

  24. Lamster IB, Grbic JT, Mitchell-Lewis DA, et al. New concepts regarding the pathogenesis of periodontal disease in HIV infection. Ann Periodontol. Jul 1998;3(1):62-75. [Medline].

  25. Ranney RR. Diagnosis of periodontal diseases. Adv Dent Res. Dec 1991;5:21-36. [Medline].

  26. Robinson PJ. Gingivitis: a prelude to periodontitis?. J Clin Dent. 1995;6 Spec No:41-5. [Medline].

  27. Sculleya DV, Langley-Evansa SC. Salivary antioxidants and periodontal disease status. Proceedings of the Nutrition Society [serial online]. 2002;61:137-143. Accessed September 28, 2008. Available at http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=804048.

Further Reading

Keywords

gingivitis, gum swelling, swollen gums, bleeding gums, gum disease, acute necrotizing ulcerative gingivitis, periodontal disease, ANUG, trench mouth, inflammation of the gingiva, plaque, bacterial plaque, gum swelling, gingival tissue, gingiva, acute infectious gingivitis, Prevotella intermedia, alpha-hemolytic streptococci, Actinomyces species, noma, cancrum oris, chronic gingivitis, blood dyscrasias, inadequate oral hygiene, halitosis, gingival hyperplasia, gingivostomatitis

Contributor Information and Disclosures

Author

James M Stephen, MD, FAAEM, FACEP, Assistant Professor, Tufts University School of Medicine; Attending Physician and Director of Medical Informatics, Department of Emergency Medicine, Associate Director, Kiwanis Pediatric Trauma Service, Tufts Medical Center
James M Stephen, MD, FAAEM, FACEP is a member of the following medical societies: American Academy of Emergency Medicine and American College of Emergency Physicians
Disclosure: Nothing to disclose.

Medical Editor

Michael Glick, DMD, Professor and Acting Chair, Department of Diagnostic Sciences, New Jersey Dental School, University of Medicine and Dentistry of New Jersey
Michael Glick, DMD is a member of the following medical societies: American Academy of Oral Medicine and American Dental Association
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Mark W Fourre, MD, Program Director, Department of Emergency Medicine, Maine Medical Center; Associate Clinical Professor, Department of Surgery, University of Vermont School of Medicine
Disclosure: Nothing to disclose.

CME Editor

John D Halamka, MD, MS, Associate Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center; Chief Information Officer, CareGroup Healthcare System and Harvard Medical School; Attending Physician, Division of Emergency Medicine, Beth Israel Deaconess Medical Center
John D Halamka, MD, MS is a member of the following medical societies: American College of Emergency Physicians, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Chief Editor

Steven C Dronen, MD, FAAEM, Director of Emergency Services, Director of Chest Pain Center, Department of Emergency Medicine, Ft Sanders Sevier Medical Center
Steven C Dronen, MD, FAAEM is a member of the following medical societies: American Academy of Emergency Medicine and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

 
 
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