Drug Induced Gingival Overgrowth

by Dr. Alec Yen

Does your gum look excessively overgrown and puffy? Do you take medications for epilepsy, immunosuppressant, or high blood pressure? If you answer "yes" to both questions, you may have a condition call "drug induced gingival overgrowth".

Anticonvulsant such as phenytoin (Dilantin) is used in the treatment for epilepsy. Gingival enlargement occurs in about 50% of patients receiving the drug.¹ It is not dependent on whether patient has good oral hygiene or not but poor home care does exacerbate the condition.

Cyclosporine (Sandimmune, Neoral) is a potent immunosuppressive agent used to prevent organ transplant rejection and to treat several diseases of autoimmune origin.² Around 30% of patients on this type of drug show some form of gingival overgrowth. Children are affected more frequently than adults.

Calcium channel blockers (Nifedipine, Amlodipine, Diltiazem) are drugs commonly prescribed to treat cardiovascular conditions such as hypertension, angina pectoris, coronary artery spasms, and cardiac arrhythmias. Around 20% of patients on Nifedipine have been found to be affected with gingival enlargement.³

Drug induced gingival overgrowth is a condition not dependent on your home care but poor plaque control can worsen the condition and initiates periodontal disease or bone loss for your teeth. It is important that you seek consultation and possible treatment from your periodontist. With his help, you can reduce the overgrowth and learn to keep the condition at its minimum. In the long run, this will help prevent tooth loss and preserve your gum health so that you can smile with confident.

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¹Seymour RA, Thomason JM, Ellis JS: The pathogenesis of drug-induced gingival overgrowth. Journal of Clinical Periodontology 1996;23:165.
²Calne R, Rolles K, White DJ, et al: Cyclosporin-A initially as the only immunosuppressant in 34 recipients of cadaveric organs: 32 kidneys, 2 pancreas and 2 livers. Lancet 1979;2:1033.
³Barclay S, Thomason JM, Idle JR, et al: The incidence and severity of nifedipine-induced gingival overgrowth. Journal of Clinical Periodontology 1992;19:311.

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