Pathology · single question
A patient with sleep apnea presents with gingival hyperplasia in the maxillary anterior region. They are NOT taking calcium channel blockers or anti-epileptics. What is the MOST likely cause of the gingival enlargement?
Show answer and explanation
Correct answer: A. Mouth breathing
Mouth breathing is the most likely cause here. Patients with sleep apnea frequently breathe through their mouth, especially at night. Chronic mouth breathing causes desiccation and irritation of the anterior gingiva, leading to a reactive/inflammatory enlargement predominantly in the maxillary anterior region. The distribution (anterior maxilla) is classic for mouth-breathing–associated gingival changes, and the question specifically rules out drug-induced causes (no CCBs or anti-epileptics).
- A. ✅ CORRECT – Mouth breathing (common in sleep apnea) causes anterior maxillary gingival irritation and enlargement from desiccation.
- B. ❌ Hereditary gingival fibromatosis is usually diffuse and familial — not specifically anterior maxilla in a sleep apnea patient.
- C. ❌ While systemic inflammation plays a role, the direct local cause is mouth breathing drying the anterior gingiva.
- D. ❌ Cyclosporine is excluded by the clinical history — not taking immunosuppressants.