Gum enlargement during adolescence can be the cause of adolescent gingivitis. The relative lack of attention to oral hygiene and the start of orthodontic treatment in adolescents can easily lead to plaque buildup on the tooth surface, which, combined with hormonal changes in the body during adolescence, makes it easier to develop adolescent gingivitis, which in turn may lead to bulbous enlargement and protrusion of the gingival papillae. After an examination at a hospital dentistry department, the doctor can mostly make a judgement based on age and local symptom presentation.