Drug Induced Gingival Enlargement

Gingival enlargement is an abnormal growth of the periodontal tissue. Several causes of gingival enlargement are known, and the most recognized is drug-induced (iatrogenic) gingival enlargement (GE) . Antiepileptic (Phenytoin PNT), Immunosuppressant (Cyclosporin A), Calcium channel blockers ( Nifedipine) are implicated. GE is the most common ADR in the young adults and children receiving PNT as antiepileptic therapy. Though poor oral hygiene and dental plaque are considered important risk factors in pathogenesis of GE, meticulous oral hygiene can minimize but not prevent the occurrence of GE. Pathogenesis is multifactorial and seems to be a modulation in inflammatory response i.e. exacerbation of the normal tissue turnover / healing signals by PNT. The most effective treatment of drug-induced gingival enlargement is withdrawal or substitution of medication i.e. PNT. Antimicrobials are found useful in alleviating the symptoms of GE. Considering alternatives to PNT or discontinuing it if feasible can definitely arrest or lessen the severity. Surgical correction remains the resort for those who have not responded well to these modalities