An Unusual Plasma Cell Gingivitis Case Related to Use of Herbal Toothpowder

Plasma cell gingivitis (PCG) is a rare benign condition of gingiva marked by dense infiltration of plasma cells into the subepithelial gingival tissue. Considered to be a true hypersensitivity reaction, it leads to edematous enlargement of gingiva extending up to the mucogingival junction. Identification and removal of the allergen leads to remission of the lesion. This case describes an unusual case of PCG.

The patient did not respond well to conventional periodontal therapy. Discontinuation of herbal toothpowder with surgical periodontal therapy led to remission of gingival enlargement. Massive enlargement responded well to removal of allergen and surgical periodontal therapy. There was no evidence of recurrence at the 18 month follow-up.

Clinicians should be aware of the adverse effects of herbal agents used in dentifrices, and caution should be exercised against excessive use of such products.