Current RMA Instruments
| Reasonable Hypothesis SOP | 17 of 2022 as amended |
| Balance of Probabilities SOP | 18 of 2022 as amended |
Changes from previous Instruments
ICD Coding
ICD-10-AM Codes: A69.1, K05.0, K05.1
Brief description
This is inflammation of the gums (also known as the gingiva). This SOP does not extend to inflammation of the deeper supporting structures of the tooth, which is covered by the SOP for periodontitis.
Confirming the diagnosis
The diagnosis is made on clinical grounds.
The relevant medical specialist is a dentist or oral surgeon.
Additional diagnoses covered by SOP
- Acute gingivitis
- Acute necrotising ulcerative gingivitis, also known as trench mouth or Vincent’s gingivitis
- Chronic gingivitis
- Desquamative gingivitis
- Gingival abscess
- Linear gingival erythema
- Peri-implant mucositis
- Plasma cell gingivitis
- Vincent’s angina
Conditions excluded from SOP
- Gingival hyperplasia and overgrowth#
- Gingival recession#
- Oral aphthae#
- Pericoronal abscess#
- Pericoronitis#
- Periodontitis*
- Periodontal abscess*
- Primary herpetic gingivostomatitis* - Herpes simplex SOP
* Another SOP applies
# Non-SOP condition
Clinical onset
Clinical onset may be based on relevant symptoms (swelling of gums, tendency for gums to bleed) but is more likley to be when first diagnosed by a dentist.
Clinical worsening
The condition is responsive to treatment and to good dental hygeine. Worsening may be evidenced by an increase in symptoms or assessed based on dental reports. The development of periodontitis or loss of teeth associated with gingivitis represents onset of a new condition and not worsening of gingivitis.