A wide variety of local irritants can produce a hyperplastic type of gingivitis in children and young adults. The irritation to the gingival tissue produced by mouth breathing is often responsible for the development of the chronic hyperplastic form of gingivitis,  particularly in the maxillary arch. All these factors should be considered contributory to chronic nonspecific gingivitis and should be  corrected in the treatment of the condition.  The importance of thorough daily oral hygiene must be emphasized repeatedly to the patients.