Final answer:
Gingival enlargement is usually caused by poor oral hygiene, leading to bacterial overgrowth, gingivitis, and potentially periodontitis if left unaddressed.
Step-by-step explanation:
The gingival enlargement occurring in this client is MOST likely caused by poor oral hygiene.
Gingival enlargement is often due to an overgrowth of oral bacteria, which is typically a direct result of insufficient dental hygiene. Bacteria such as Streptococcus and Actinomyces species, thriving in an unhygienic oral environment, can lead to gingivitis, the first stage of periodontal disease. If unchecked, gingivitis can evolve into periodontitis, where gum recession and erosion of cementum may cause tooth loss.
Factors such as hormonal changes can contribute but are not the most common cause for gum enlargement. On the other hand, practicing good oral hygiene can prevent the progression of periodontal disease, as it helps control the bacterial overgrowth responsible for inflammation and tissue damage in the gums.