Desquamative Gingivitis: Medical and Surgical Management of Oral Lesions

Clinical conditions known as desquamative gingivitis (DG) are characterized by erythema, ulceration, erosion, and blistering or desquamation of the marginal and attached gingiva, which can be localized or widespread. DG is a clinical description of oral lesions rather than a definitive diagnosis. In many common forms of DG, the initial presentation is typically desquamation or erosion on the labial surface of anterior teeth. Although DG may be caused by a broad range of local and systemic conditions, pemphigus vulgaris, oral lichen planus, and mucous membrane pemphigoid are the most common triggers. While DG does not directly cause attachment loss or alveolar bone destruction, it can lead to oral discomfort and impair proper oral hygiene, which poses a long-term risk to dental and periodontal health. Because many disorders associated with DG may involve systemic presentations, both oral and extraoral symptoms must be assessed. Further, some of these conditions demonstrate significant morbidity and, in some cases, lifethreatening complications. Given the wide range of possible manifestations and the complexity of diagnosis, identification and management of DG often requires a multidisciplinary approach to ensure optimal patient care. Initial recognition of DG and rapid identification of a definitive diagnosis is critical to ensuring patients' health and comfort. This article reviews the clinical characteristics, diagnostic approaches, and treatment protocols for mucocutaneous diseases associated with DG.