Gingival hyperplasia refers to an increase in gingival volume due to an increase in the cellular component of the gingival tissue and can be seen in infectious diseases of the gingival tissue caused by plaque biofilm or in non-inflammatory changes caused by factors other than local irritation. Diagnosis is made according to the differences in medical history, medication history, gingival color, shape, texture, and site of enlargement. 1, chronic gingivitis The presence of plaque and tartar; gingival color, shape and texture changes: bright red or dark red gums, thickened gingival margins, rounded and hypertrophied gingival papillae, and sometimes bulbous hyperplasia. In a few cases with severe inflammation, gingival margin erosion or granulomatous hyperplasia may occur. The gingiva sometimes has a flabby and fragile surface. On probing, the gingival sulcus bleeds and the gingival sulcus floor should be located at the enamel-dental bone boundary without clinical attachment loss. There is no indication of bone resorption at the apex of the alveolar ridge on imaging. 2, adolescent gingivitis (1) The patient is in adolescence; oral hygiene is fair or poor; gingival redness is obvious, and the gingival papillae are often bulbous, shiny and soft. Light irritation is easy to bleed, mostly on the labial side of the front teeth. There may be bad breath. (2) There can be misalignment, orthodontic appliances, bad habits, etc. The degree of gingival hypertrophy and hyperplasia does not match the degree of local stimulation, i.e., the gingival tissue has a strong inflammatory response. 3, gingivitis during pregnancy (1) Inflammation of the gingival margin and gingival papillae can occur in individual teeth or the entire gingiva, but is heavier in the anterior region. Localized plaque and other irritants are present. Gingivitis is usually present to varying degrees before pregnancy, and symptoms such as bleeding gums when brushing teeth and eating food are evident from 2 to 3 months of pregnancy onwards. (2) Gingival tumors in pregnancy occur in the interdental papillae of individual teeth, usually appearing in the third month of pregnancy, rapidly proliferating, bright red or dark purple in color, irregular in shape, may be lobulated, with or without a tip, loose and soft in texture, easy to bleed, and local irritants can usually be found, such as root remnants, tartar, and poor restorations. After delivery, most gingival tumors can gradually shrink on their own, but local irritants must be removed to make the lesion disappear completely. 4, drug-related gingival hyperplasia (1) History of systemic diseases, history of drug use. (2) interdental papillae or gingival margin hyperplasia in the form of globular, mulberry-like or lobulated, light pink, firm and slightly elastic, severe cases prevent chewing. It is common in the anterior region, but can also occur in the entire gingiva. (3) It is usually painless and may be accompanied by severe gingival inflammation such as bad breath, bleeding from brushing and periodontal pus. (4) Loosening and displacement of teeth due to extrusion of the hyperplastic gums (mostly seen in the upper front teeth). (5) The condition can be aggravated by poor oral hygiene, trauma, dental caries, bad fillings and orthodontic appliances, etc. 5, gingival fibromatosis (1) may have a family history. A small number of them develop in early childhood and can occur as early as after the eruption of milk teeth. (2) The gingival margin, gingival papillae and attached gingiva can be accumulated throughout the mouth, with the palatal side of the maxillary molars being the heaviest. (3) It often covers more than 2/3 of the tooth surface. (4) The hyperplastic gingiva is normal in color, has tough tissue, and does not bleed easily. Sometimes there is difficulty in tooth eruption. (6) Gingival tumors (1) Gingival papillae are round, oval, and sometimes lobulated verrucous growths. The size varies. (2) With or without a clitoris. Those with a tip are polyp-like, while those without a tip have a broad base. (3) Soft and red in color (vascular and granulomatous) or hard and tough with a pinkish color (fibrous). (4) Generally painless; pain may be felt when ulceration occurs on the surface of the swelling. (5) X-ray shows localized alveolar bone resorption or widening of the periodontal membrane.