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Drug-Induced Gingival Hyperplasia

Purpose: To evaluate a patient for drug-induced gingival hyperplasia.

Description

Gingival hyperplasia may occur in patients taking certain medications. This is not a true hyperplasia with cellular proliferation, but rather is associated with an increase in the extracellular tissue volume. Early recognition and intervention can help reduce serious complications.


 

Precipitating drugs:

(1) cyclosporine in transplant patients

(2) calcium channel blockers (calcium channel antagonists)

(3) anticonvulsants, especially dilantin (phenytoin)

 

Factors increasing the risk:

(1) high dose cyclosporine therapy

(2) taking more than one precipitating agent

(3) poor oral hygiene

 

Complications:

(1) pain

(2) disfigurement

(3) mechanical interference with speech or eating

 

Management:

(1) good oral hygiene with regular dental cleanings (while this may not prevent gingival hyperplasia, it will help reduce the severity)

(2) antibiotic therapy with azithromycin

(3) discontinuation of precipitating drugs when possible. For patients with severe hyperplasia receiving cyclosporine, conversion to tacrolimus.

(4) severe hyperplasia may require surgical or laser resection of tissue

 


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Specialty

Objective

ICD-10