Drug-Influenced Gingival Enlargement

Drug-influenced gingival enlargement (DIGE) is a condition where the gum tissue becomes excessively enlarged as a side effect of certain medications. This overgrowth can interfere with oral hygiene, affect appearance, and may cause discomfort during chewing or speaking. DIGE typically occurs in individuals who are genetically predisposed and is worsened by poor oral hygiene.

The following classes of systemic medications are most commonly linked to gingival enlargement:

• Anticonvulsants (seizure medication e.g., Phenytoin)
• Immunosuppressants (used to suppress organ rejection e.g., Cyclosporine)
• Calcium Channel Blockers (used to treat hypertension e.g., Nifedipine, Amlodipine)

Not all individuals taking these medications will experience DIGE, but the risk increases in the presence of dental plaque and inflammation.

1. Plaque Control and Oral Hygiene
The first and most important step in managing DIGE is establishing good oral hygiene. This includes:

• Proper toothbrushing and flossing techniques
• Professional plaque removal through scaling and root debridement

These measures can help reduce inflammation and, in most cases, lead to resolution of this condition

2. Medication Review
In some cases, your dentist or periodontist may liaise with your primary physician to explore the possibility of:

• Adjusting the dose of the causative medication
• Switching to an alternative medication with fewer oral side effects

Note: Medication changes should never be made without medical advice and supervision.

3. Surgical Intervention

If the overgrowth persists despite good oral hygiene and medication adjustment, surgical treatment may be necessary. This procedure involves reshaping and removing the excess gum tissue to restore both function and appearance.

However, it's important to note that:

• Gingival enlargement may recur, especially if the medication is still being used, and if good oral hygiene is not maintained
• Repeat surgeries may be required in some individuals

4. Maintenance and Follow-Up
Long-term success in managing DIGE depends on:

• Regular professional dental cleaning
• Ongoing reinforcement of proper oral hygiene habits
• Periodic monitoring through a supportive periodontal maintenance program

Drug-influenced gingival enlargement is a manageable condition when identified early. Through a combination of good oral hygiene, professional care, and collaboration with your medical provider, the condition can often be controlled or even reversed. If you are taking any of the medications listed above and notice changes in your gum tissue, speak with your dentist for an evaluation.