Desquamative Gingivitis Causes — ORE Part 1 MCQ
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Correct answer: A — Dental plaque-induced gingivitis
Explanation lettering: D = shown as B · B = shown as D
The answer is A. Dental plaque-induced gingivitis is fundamentally distinct from desquamative gingivitis (DG). DG is defined as erythema unrelated to dental plaque with characteristic epithelial desquamation, erosion, and vesiculation due to separation of epithelium from connective tissue. Plaque-induced gingivitis presents with swelling, bleeding, and plaque-dependent inflammation—absent in true DG. Options B (mucous membrane pemphigoid), C (pemphigus vulgaris), D (oral lichen planus), and E (linear IgA disease) are all well-established autoimmune and mucocutaneous causes of DG, with lichen planus being the most common (75% of DG cases) and the others representing important differential diagnoses. Although secondary plaque accumulation may occur as a consequence of DG pain and poor oral hygiene, primary plaque-induced gingivitis does not produce the pathological desquamative pattern and is LEAST likely to be the underlying cause of DG presentation.
Reference: Leão JC, Ingafou M, Khan A, et al. Desquamative gingivitis: retrospective analysis of disease associations of a large cohort. Oral Dis. 2008; and multiple recent narrative reviews (2022–2024) on DG pathophysiology and classification, https://pubmed.ncbi.nlm.nih.gov/21050381/