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PERIO - Periodontal Practice Today
PERIO - Periodontal Practice Today 5 (2008), No. 1     3. Apr. 2008
PERIO - Periodontal Practice Today 5 (2008), No. 1  (03.04.2008)

Page 21-28

Plasma cell gingivitis associated with khat chewing
Rawal, Swati Y. / Rawal, Yeshwant B. / Anderson, Kenneth Mark / Bland, Paul S. / Stein, Sidney H.
Plasma cell gingivitis (PCG) is characterised by a heavy plasma cell infiltration into the gingival con-nective tissue. It has been associated with the use of flavouring agents like cinnamon and mint incandy, chewing gum and herbal toothpastes. PCG secondary to khat (Catha edulis) chewing has recently been recognised. Khat is a psycho-stimulating herb that is cultivated and used in East Africaand the Arabian Peninsula. It produces a stimulating and euphoric effect on its users. Plasma cell gingivitis in a khat user is presented. A 40-year-old male presented with a generalised diffuse erythema and painful gingival enlarge-ment. He also reported bleeding upon eating and brushing. Generalised periodontal pocketing andmoderate to severe attachment loss were detected on probing. Radiographs revealed generalisedalveolar bone loss. A gingival biopsy revealed a dense infiltrate of plasma cells in the connective tissue. A histopathological diagnosis of plasma cell gingivitis was made. It was revealed that the patient was a Yemeni immigrant and a habitual khat chewer for the last 10 years. A marked improve-ment in gingival health was noted a few weeks following cessation of the khat chewing habit.Gingival erythema and swelling further diminished following initiation of oral prophylaxis.A diagnosis of plasma cell gingivitis associated with khat use was made. A worldwide populationof immigrants habituated to khat chewing could potentially increase the incidence of plasma cell gingivitis. Recognition of this habit and its implications on periodontal health is emphasised.

Keywords: gingivitis, khat, periodontitis, plasma cell