Causes of gum swelling not directly caused by plaque include a multitude of other causes, including hereditary, infectious (bacterial/viral/fungal), auto-immune or inflammatory, reactive, tumours, nutritional, drug-related and traumatic causes.
Another cause of persistent inflammation of the gums in the absence of plaque is altered passive eruption of the teeth where there are insufficient attached gingiva and biologic width. This can be assessed using CBCT scans of the underlying bone and gum tissue.
These are grouped under non-plaque induced gingivitis.
The appropriate treatment depends on identifying the underlying cause. Since there are so many potential causes of non-plaque induced gingivitis, evaluation by a dentist is essential.
