Drug-induced gingival enlargement is a
side-effect of certain drugs where the gingival tissue is not the intended
target organ. The key offending drug classes are anticonvulsants,
immunosuppressants, and calcium channel blockers. It is estimated that 50% of
adults treated with phenytoin experience gingival enlargement, 30% with
cyclosporine, and 20% with nifedipine. This overgrowth impedes proper dental
hygiene and, apart from the cosmetic damage, causes painful chewing and eating.
The common mechanism of action at the cellular level of all these three
categories of dissimilar drugs appears to be inhibition of cation influx,
particularly sodium and calcium ions. The modalities of
treatment are medical and surgical. Medical management is the first line of
therapy and includes discontinuing or changing the medication must be placed
under consideration. Surgery is reserved for recurrences or cases that persist
despite good medical treatment.
