Gingival lesions not induced by plaque include those caused by specific bacterial infections (streptococcus infections, tuberculosis, gonorrhoea, syphilis). This also includes gingival participation during fungal infections. Gingival manifestations of systemic diseases (lichen planus, pemphigoid) are also included in this group.

Allergic reactions to materials in dental medicine (e.g., precious metals, quicksilver, nickel and acrylic), ingredients in medication, toothpastes, mouth wash etc. and additives in drinks or chewing gum may also cause gingival disease and changes.

Traumatic gingival lesions are predominantly caused by aggressive brushing: too frequently, with an overhard brush and/or excessive application pressure.