Current status of treatment modalities for drug-induced gingival overgrowth

Gingival hyperplasia (overgrowth) is a well-documented unwanted effect, associated with phenytoin, the calcium channel blockers, and cyclosporin. The pathogenesis of drug-induced gingival hyperplasia is uncertain. However, the identification of risk factors associated with both the prevalence and severity of drug-induced gingival hyperplasia is important for all parties involved with this unwanted effect. Prevalence of gingival hyperplasia with phenytoin, the calcium channel blockers, and cyclosporin is approximately 50%, 10-20%, and 8-70%, respectively. The inflammatory components of drug-induced gingival hyperplasia can be managed effectively for the majority of patients with a plaque control program and nonsurgical periodontal therapy including oral hygiene instruction, scaling and root planing coupled with continued periodontal maintenance procedures. After reevaluation, some patients may need surgical periodontal therapy and maintenance procedures. Maintenance therapy including appropriate oral home care appear to be effective in controlling the drug-induced gingival hyperplasia and in maintaining clinical improvements for a long time.