Reactive Lesions of the Gingiva: Diagnosis and Treatment Options

Reactive lesions found on the gingiva are common and tend to be non-neoplastic growths. They are usually not painful and are often overlooked by the patient until they become symptomatic or are identified by their dental healthcare provider. Since they may be present for weeks to months, it is common to see ulceration of the surface tissue due to trauma. They have a recurrence rate of 5 – 20% after excision depending on the diagnosis, the completeness of the surgical removal, and the ability to address the local irritating factors associated with their etiology. It is recommended to obtain histologic diagnoses for the lesions since their clinical appearances can be similar amongst various lesions, but the recurrence rates are different. The treatment for all common reactive lesions includes surgical excision by scalpel, laser, or radial/ electrosurgery. Treatment should also include removal of the underlying etiology through curettage of tooth accretions, replacement of defective restorations, and elimination of traumatic habits. Regular dental hygiene maintenance with professional follow-up care should reduce the incidence of recurrence for most types of gingival lesions. This review of identification and treatment of gingival lesions includes the newly recognized localized juvenile spongiotic gingival hyperplasia, which should become part of the differential diagnosis for reactive lesions in juvenile patients.