Effect of Folic acid supplementation on Desquamative gingivitis

Desquamative  gingivitis (DG) is a non-plaque induced lesions of the oral mucosa, characterised by erythema, erosion, desquamation of the gingival   and  associated  oral mucosa .These lesions are quite unpredictable in their clinical course and are quite challenging for the clinician to treat, as sometimes they are refractory to current standard  therapeutic modality. Folic acid is one of the vitamin B complex, acts as co factor   in  DNA methylation which is essential for DNA synthesis and repair.Evidence has shown that  folic acid supplementation plays   important role in chemoprevention of gastric carcinogenesis by   increasing epithelial apoptosis in premalignant lesions by up regulating   P53 gene and down regulating Bcl-2 gene. It has been shown in double-blind randomized trials that folic acid both in systemic supplementation and local delivery increased the resistance of gingival cells to local irritants and decreased gingival inflammation .In the light of above evidence we propose to study the effect of Folic acid supplementation on DG with the objective to compare the clinical outcomes and salivary TNF-alpha levels in DG patients receiving standard local steroid therapy versus standard local steroid therapy with adjunct systemic oral folic acid supplementation.