25. White gingivae

A 40-year-old woman came for a routine dental check-up. Clinical examination of her lower anterior teeth revealed tooth surface loss (attrition) and gingival abnormalities, such as recession, ulcerations without destruction of interdental papillae, mild swelling with loss of gingival striping with white diffuse lesions in both free and attached gingivae. These gingival lesions (Figure 1) were slightly sensitive with brushing and not associated with other lesions in her mouth, skin and other mucosae. The patient suffered only from allergic rhinitis, occasionally used anti-histamine tablets and used cinnamon chewing gum regularly.

The gingivae of this patient show a mild inflammation causing loss of stippling and white diffuse lesions due to Lichen planus. Lichen planus is a chronic inflammation disease which affects the gingivae, either as desquamative gingivitis or as white lesions intermingled with erythema, and small superficial ulcerations. It often affects only the mouth and, rarely, its lesions are limited in the gums, as seen in this patient.