To highlight the importance of considering tuberculosis in the differential diagnosis even in the absence of confirmation from several investigations and diagnostic aides.

Tuberculosis is a common infectious granulomatous disease caused by various strains of mycobacteria. An oral lesion when seen in association with tuberculosis is very rare and in most cases is noticed secondary to pulmonary forms.

We report a case of primary gingival tuberculosis in 20-year-old female patient who presented with treatment resistant gingivitis. Patient had no evidence of disease elsewhere in the body and several diagnostic tests also failed to reveal the presence of the causative organism. Resolution of gingivitis was noted following a therapeutic trial of antitubercular drugs.

Therefore the importance of including tuberculosis in the differential diagnosis of inflammatory disorder of the gingiva is very essential in order to avoid one of the most lethal forms of infections often overlooked.

It is essential to consider tuberculosis as one of the differential diagnosis in India even when several diagnostic tests are negative for tuberculosis.

Gelli V, Mutalik SS, Mutalik VS, Manyam R. Primary Gingival Tuberculosis Diagnosis: A Difficult Endeavor. J Contemp Dent Pract 2013;14(1):137-139.