Nonplaqueinduced

Nonplaque-induced refers to gingival diseases and lesions that cannot be explained by dental plaque as the primary cause. These conditions may arise from systemic factors, genetic or developmental conditions, infections, allergies, or trauma, and they can affect any region of the gingiva. Because their gingival involvement is not solely driven by plaque, they often require medical or dental interventions beyond standard plaque control.

Common etiologies include drug-influenced gingival enlargement (for example, from phenytoin, cyclosporine, or certain calcium channel blockers), nutritional deficiencies such as vitamin C deficiency, and hereditary or developmental gingival conditions like hereditary gingival fibromatosis. Mucocutaneous diseases—such as lichen planus, mucous membrane pemphigoid, and pemphigus vulgaris—can present with gingival involvement, as can infectious states (primary herpetic gingivostomatitis, candidiasis, and other fungal or viral infections). Allergic or irritant reactions to dental materials or toothpaste ingredients, as well as traumatic or chemical injuries, may also produce nonplaque-induced gingival lesions.

Diagnosis relies on clinical history, examination, and often the exclusion of plaque-associated disease; biopsy or laboratory tests may be necessary for suspected mucocutaneous or systemic conditions. Management targets the underlying cause and is usually multidisciplinary. This may involve substituting or adjusting medications in collaboration with a physician, treating infections with appropriate pharmacotherapy, using immunomodulatory or anti-inflammatory therapies for mucocutaneous diseases, or surgical management for fibromatosis or other persistent lesions. While good oral hygiene remains beneficial, it is not the sole or primary treatment strategy for nonplaque-induced gingival conditions.