Gingival Diseases & Enlargements
Drug-Induced Enlargement
Three classic drug groups: Phenytoin (anticonvulsant, classic), Cyclosporine (immunosuppressant), and Nifedipine (calcium channel blocker).
ANUG (Necrotising Ulcerative Gingivitis)
Punched-out, craterlike interdental papillae, a grey pseudomembrane, pain and fetor; associated with stress, smoking and immunosuppression; fusospirochaetal flora.
Desquamative Gingivitis
Not a disease itself but a clinical sign — red, peeling gingiva commonly due to mucous membrane pemphigoid, pemphigus vulgaris, or lichen planus.
Exam Tips ⭐
Drug enlargement = Phenytoin/Cyclosporine/Nifedipine; ANUG = punched-out papillae + pseudomembrane; desquamative gingivitis = pemphigoid/pemphigus/lichen planus.
📝 Practice MCQs — Gingival Diseases & Enlargements
Q1. Which drug classically causes gingival enlargement?
A. Amoxicillin
B. Phenytoin
C. Paracetamol
D. Metronidazole
Show Answer
✅ Answer: B
Phenytoin is the classic cause of drug-induced gingival overgrowth.
Q2. Punched-out interdental papillae are characteristic of:
A. ANUG
B. Pyogenic granuloma
C. Fibroma
D. Leukoplakia
Show Answer
✅ Answer: A
ANUG shows craterlike punched-out papillae with pseudomembrane.
Q3. Desquamative gingivitis is commonly a manifestation of:
A. Caries
B. Mucocutaneous diseases (pemphigoid/lichen planus)
C. Fluorosis
D. Abrasion
Show Answer
✅ Answer: B
It reflects pemphigoid, pemphigus or lichen planus.
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