Desquamative Gingivitis
The term 'desquamative gingivitis' is a clinical
description, not a diagnosis.

It is used for conditions in which the
gingivæ (gums)
appear red or raw.  Usually the whole of the attached
gingiva of varying numbers of teeth is affected.

This is a clinical descriptive term used for non-specific
gingival (gum) manifestation of several chronic muco-
(effecting the skin and ‘wet’ surfaces of the
body) diseases.

With rare exceptions, an
auto-immune mechanism is
Cicatricial Pemphigoid and Lichen Planus
are the most common
auto-immune diseases that manifest
Desquamative Gingivitis.

Less commonly are
Bullous Pemphigoid, Pemphigus,
Linear IgA Disease, Epidermolysis Bullosa Acquisita
Chronic Ulcerative Stomatitis, Discoid Lupus
Erythematosus and Psoriasis.

Desquamative Gingivitis has also been associated with:

  • Chemical damage, such as reactions to sodium lauryl
    sulphate in toothpastes.
  • Allergic responses.
  • Drugs.
  • Pyostomatitis vegetans.
Desquamative Gingivitis presents as erythema (reddening) and œdema (swelling)
of the marginal and attached attached
gingiva (gum).

The ‘
facial’ (that is, the surfaces facing out towards the lips and cheeks) surface is
more frequently affected than the
lingual / palatal gingivæ.  Spontaneous
desquamation of the epithelia, blister formation and areas of superficial erosions
are common.

Some patients make no complaint, but the main complaint is of persistent soreness
of the
gingivæ; worse when eating acerbic or spicy foods such as tomatoes, citrus
fruits and others.

desquamation may vary from mild, almost insignificant small patches to
widespread redness a ‘glazed’ appearance.

In addition to a full history and examination, biopsy examination and appropriate
histo-pathological and immunological investigations are frequently indicated.

Some other conditions can present with redness or ulcers rather than the
erosions typical of Desquamative Gingivitis and should be excluded.

Such appearances may be seen in:
  • reactions to various mouthwashes, chewing gum, medications and dental
  • candidiasis (Thrush)
  • lupus erythematosus
  • plasma cell gingivitis
  • Crohn’s disease, sarcoidosis and oro-facial granulomatosis
  • leukæmias
  • factitial (self-induced) lesions.

The treatment of
desquamative gingivitis consists of:

  • improving the oral hygiene
  • minimising irritation of the lesions
  • specific therapies for the underlying disease where available
  • often local / systemic immuno-suppressive or dapsone therapy, notably cortico-
    steroids.  Cortico-steroid creams used overnight in a soft polythene splint, may

Useful Articles:

Oral Features of Mucocutaneous Disorders.  Committee on Research, Science and
Therapy.  American Academy of Periodontology 1994.

Dental Update 1999.  Orofacial Disease - Update for the Dental Clinical Team 7.
Complaints Affecting Particularly the Palate or Gingivae

Australian Dental Journal 2003.  Desquamative Gingivitis.  A Sign of
Mucocutaneous Disorders

Journal of IMAB - Annual Proceeding (Scientific Papers) 2007.  Desquamative
Gingivitis as a Symptom of Different Mucocutaneous Disorders
Photo showing Desquamative Gingivitis in Oral Lichen
Photo showing Desquamative Gingivitis in Cicatrial
Photo showing Desquamative Gingivitis in Benign Mucous Membrane Pemphigoid