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Gingival hyperplasia can be drug-related

Some drugs can cause gingival hyperplasia. Reducing the dose, halting treatment and good oral and dental hygiene are generally sufficient to reduce or stop the lesions.

There are various causes of gingival hyperplasia (or overgrowth), including drug treatments.

Gingival hyperplasia starts with the front interdental tissue (often that of the upper jaw) and then spreads to the back within several months, whatever the drug concerned. It can continue spreading over several years if exposure persists.

The consequences are generally of a cosmetic nature, but can sometimes include dental occlusion and difficulties in swallowing or enunciation, and chewing can be painful.

These are aggravated by plaque caused by poor oral and dental hygiene,  by pre-existing inflammation, or by a  combination of several drugs that can cause gingival overgrowth.

Young patients seem more exposed. The duration of the drug treatment and the dosage are sometimes key factors.

Few drugs are implicated, chiefly some anti-epileptics such as phenytoin, calcium channel blockers such as nifedipine, and immunosuppressants, ciclosporin in particular.

When one of these drugs is prescribed, it is advisable to maintain rigorous oral and dental hygiene and to have regular scaling sessions, so as to reduce the risk of lesions. Halting the treatment or reducing the dosage when possible generally results in the disappearance of the adverse effects.

©Prescrire 1 December 2011

"Drug-induced gingival hyperplasia" Prescrire Int 2011; 20 (122): 293. (pdf, subscribers only)

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