Gingival hyperplasia can be associated with poor oral hygiene, underlying systemic disease, or as a medication side effect. Oral hygeine may be impaired by developmental disability or poor manual dexterity as a result of stroke, osteoarthritis of the hands, or Alzheimer's disease or other dementia.
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Pazianas M, Miller P, Blumentals WA, et al. A review of the literature on osteonecrosis of the jaw in patients with osteoporosis treated with oral bisphosphonates: prevalence, risk factors, and clinical characteristics. 2007; 29(8):1548-58.
Kumar A, Kumar V, Singh J, et al. Drug Induced Gingival Hyperplasia: An Updated Review. Int J of Pharm & Toxicology Science. 2011; 1: 34-42.