Plasma cell gingivitis among herbal toothpaste users: a report of three cases

The aim of this article is to present a brief review of plasma cell gingivitis (PCG) along with reports of three cases with varying clinical presentations of the condition associated with the use of herbal toothpaste.

PCG is a rare benign condition of the gingiva characterized by sharply demarcated erythematous and edematous gingivitis often extending to the mucogingival junction. This is considered a hypersensitive reaction. The histological appearance consists of a dense infiltration of normal plasma cells separated by collagenous stroma, usually confined to the free and attached gingiva. The lesion can be eliminated by identifying and avoiding the source of the allergen.

Three patients ages 26, 27, and 36, respectively, presented with acutely inflamed gingival and a history of recently switching to herbal toothpaste. The gingiva bled readily on probing. Blood tests and gingival biopsy were not contributory. Patients were advised to refrain from the use of herbal toothpaste, and, along with periodontal treatment, the condition underwent remission within a week to two weeks in all three cases.

As more and more herbal products are gaining popularity, clinicians should be aware of some of the untoward effects of these products. Since PCG mimics lesions associated with leukemia and myeloma an early diagnosis of the condition is vital.