The diagnosis of gingival hyperplasia is sometimes difficult because of great aetiological diversity. Hyperplastic changes of different aetiology and pathogenesis may have similar clinical appearance. In some patients they are connected with systemic administration of various drugs. The aim of this paper is to present three groups of drugs that may produce gingival hyperplasia.
Phenytoin, the most frequently prescribed drug in the treatment of epilepsy for over 50 years, causes chronic gingival hyperplasia in more than 50 % of patients. The nature of this drug reaction is still unknown, although there is evidence to suggest that the hyperplasia represents an exaggerated form of reactive chronic gingivitis, which can be prevented if optimal oral hygiene is maintained from the start of treatment.
Cyclosporine is an immunosuppressive drug which has been widely used in all branches of transplant surgery for the prevention of graft rejection. It is also used in some autoimmune diseases. The oral side effect of cyclosporine is gingival hyperplasia, which affects from 8 to 82.8 % of patients and is mostly associated with secondary inflammation.
Calcium channel blockers are used to treat hypertension, angina pectoris and arrhythmias. In patients receiving dihydropyridines (nifedipine, amlodipine), the reported rates of side effects in the oral cavity range from 3 to 83 %. Bacterial plaque often causes additional inflammation of the enlarged gingiva. The hyperplasia subsides if the drug dose is reduced.