Understanding Linear Gingival Erythema

Linear gingival erythema (LGE) is a type of gingivitis that’s common among people living with HIV. This gum disease causes inflammation, creating a red line where the gums meet the teeth.

While LGE is also seen in people who don’t have HIV, it’s a common complication of the viral disease. Find out what it means to have LGE and what to do next.

What is linear gingival erythema?

LGE is the medical term that describes redness around the gums. Linear indicates a line pattern, and erythema means redness. Gingival refers to the gums.

This condition used to be referred to as HIV-gingivitis, because it was one of the oral conditions commonly seen with HIV. However, as it came to be understood as a condition linked more to the weakness of the immune system than the virus itself, the condition was renamed.

LGE is a type of opportunistic condition. When there’s a change in the natural balance of your body, other conditions can develop. Opportunistic infections are common in people who are immunocompromised, including people with HIV.

What are the symptoms of linear gingival erythema?

It can be difficult to distinguish LGE from other gum conditions, but there are a few specific signs of the condition. Symptoms of LGE include:

  • a red line measuring 2 to 3 millimeters along the gum line
  • tiny red dots near the line, called petechiae
  • red spots or lesions that may bleed
  • gum discomfort
  • bad breath
  • loose teeth

Why do people get linear gingival erythema?

Linear gingival erythema can be misdiagnosed as other types of gingivitis, so it’s important that a medical professional or dentist knows your full medical history. People with HIV or other conditions that weaken the immune system may lose some of their natural ability to keep bacteria and fungus under control.

Bacteria and yeasts normally live in the body but are kept at manageable levels by your immune system. When the immune system isn’t working properly, these organisms can grow out of control and cause problems like LGE. LGE is linked to candidiasis, a type of yeast that can also cause conditions like oral thrush and yeast infections.

As yeasts take over healthy tissues, the fungal growth infects healthy tissue, causing pain, itching, and other uncomfortable symptoms. Anyone can develop a yeast overgrowth in many parts of the body, but oral fungal infections like LGE are most common in people who have conditions that hinder the immune system, like:

  • diabetes
  • cancer
  • HIV/AIDS
  • dry mouth

Other factors that can contribute include:

  • wearing dentures
  • taking antibiotics
  • using steroids or corticosteroids
  • smoking cigarettes

Can you prevent linear gingival erythema?

If you have a condition or take a medication that suppresses your immune system, you’re already at a higher risk of developing conditions like LGE. However, there are steps you can take to prevent it.

Good dental hygiene and taking precautions like rinsing your mouth after using inhaled corticosteroids can help reduce your chances of developing LGE and other oral fungal infections.

What are the current treatment options?

Typically, oral yeast-related infections are treated with medications like:

  • clotrimazole
  • miconazole
  • nystatin
  • fluconazole

These are usually applied by swishing them around in the mouth and then spitting them out. Treatment usually lasts for 1 to 2 weeks.

Treatment may also involve:

  • removal of dead or damaged tissue
  • antibiotics
  • good oral hygiene practices
  • checking the status of your immune system

What’s the outlook for people who get linear gingival erythema?

For people with HIV and others who are immunocompromised, LGE and other opportunistic infections are considered serious complications. Without treatment, LGE can spread down into the throat or progress to more severe oral infections like necrotizing ulcerative periodontitis (NUP).

NUP is a severe and quickly progressing over just a few months. It is an oral infection that causes:

  • bone and tooth loss
  • severe pain
  • bleeding
  • severe mouth odor

The takeaway

Linear gingival erythema is a condition that’s related to a fungal infection of the gums. It appears as a red line along the gum line and causes pain and sometimes bleeding.

This condition is one of the most common oral complications of HIV. However, people with HIV aren’t the only ones can who develop LGE. The condition can also affect others who have compromised immune systems.

Good oral hygiene is key to preventing fungal overgrowth and mouth infections who are at higher risk for LGE.

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