Change of gums from a thin, well-adapted, continuous covering around the teeth to a thick swollen red mass, may not only appear unsightly, but also acts as a platform for further destruction of healthy teeth and supporting bone.

CAUSES
1. Most common cause is infection of the “gingiva”, by a thin covering of food and bacteria on the tooth surface called “Plaque”. The bacterial content of this plaque trigger a response from the gingiva, which results in a swelling. The swelling is caused by accumulation of white blood cells and fluids, which in turn counteracts the action of the bacteria.
2. Due to certain normal condition such as pregnancy and puberty, there is swelling of the gingiva seen. This swelling is an abnormal response to the normal bacteria present in the mouth. The abnormal response is a result of hormonal changes or variation seen during the above-mentioned conditions.
3. Certain disease or deficiency condition may also result in swollen gingiva
E.g. 
  - Vitamin C deficiency. 
  - Leukemia 
  - Tumors or abnormal growth on the gingiva, which may 
     be harmless or, can be cancerous.
4. Certain drugs used by the patient may result in increased size of the gingiva as a side effect.
E.g. 1. Phentoin used in epileptic Fits. 2. Nifidipine used for blood pressure.

SYMPTOMS
1. Pain may or may not be present.
2. If the cause is infection then, the initial stage is 
indicated by the presence of bright red gingiva.
- As the infection progresses the color changes from red to bluish red to deep blue.
3. The gingiva becomes soft and spongy; rarely it may become thickened due to formation of scar tissue.
4. Bleeding of the gingiva is another common symptom in the advanced stage. 
5. Swelling caused by the drugs is usually very hard and thick. The gingiva will become swollen even after treatment of the swelling. The swelling occurs only when the drug is administered for a certain period of time.