Gingival enlargement is a common problem among adolescent orthodontic patients. Adolescents’ hormone levels are changing dramatically, and with poor oral hygiene control, poor plaque control and local irritation of the gums by the orthodontic appliance, this can easily lead to significant inflammation and swelling of the gums, with compensatory tissue growth resulting in bulbous or nodular enlargement, usually 1 to 2 months after orthodontics. Some patients may also suffer from gingival hyperplasia due to hypersensitivity to the low concentration of nickel ions in the orthodontic appliance.
It has also been suggested that orthodontic forces have some influence on the occurrence of gingival enlargement, but the specifics of this have yet to be studied.