Systemic disease or periodontal disease? Distinguishing causes of gingival inflammation: a guide for dental practicioners: PART II: cancer related, infective, and other causes of gingivial pathology

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Objectives: Periodontitis and gingivitis are highly prevalent inflammatory diseases of the oral cavity, and typically are characterized by the presence of dental plaque. However, other causes of oral inflammation exist, which can resemble plaque-induced gingivitis and periodontitis, and may thus first be seen by a dental practitioner. This paper aims to provide dentists with an understanding of the manifestation of systemic diseases to the periodontium and highlights anamnestic and clinical clues important for distinguishing between plaque-induced and non plaque-induced lesions.

Data sources: Whilst in the first part of this publication immune-mediated and hereditary conditions as causes of gingival lesions were discussed, the second part highlights cancer-related gingival lesions as well as those caused by specific pathogens, medication or malnutrition. A clear clinical, epidemiological and visual overview of the different conditions is provided.

Conclusions: Early diagnosis of non plaque-related causes of gingival lesions can be vital for affected patients. Therefore, dental practitioners should be aware of the various manifestations of systemic diseases to the periodontium.


Original languageEnglish
Pages (from-to)1029-1034
JournalBritish Dental Journal
Publication statusPublished - 20 Dec 2019


  • periodontitis, gingivitis, no plaque-induced inflammation, cancer, infection