Title: Risk factors for drug-induced gingival overgrowth
Authors: RA Seymour, JS Ellis, JM Thomason
Journal: Journal of Clinical Periodontology 2000
Resident: Margaret Cannon
Due to the high frequency of clinical signs and expressions of drug-induced gingival overgrowth still seen by periodontists, this article works to identify and quantify the various risk factors associated with both the development and expression of the drug-induced gingival changes.
Risk factors evaluated included: age, sex, drug variables, concomitant medication, periodontal variables, and genetic factors.
- Age has been reported as risk factor for phenytoin- particularly in teenagers- and cyclosporine- children more than adults.
- Age was not found to be a factor but for calcium channel blockers – slight confusion with this because Ca Channel blockers are usually only rx-ed to 40+ year old patient.
- Gender and race are not important risk factors for gingival hyperplasia.
- Drug dosage is a poor predictor of gingival changes, but drug concentration in saliva is a positive predictor
- The combination of some drugs produces more gingival overgrowth than if either drug was used singularly
- Plaque scores and gingival inflammation appear to exacerbate the expression of drug-induced gingival overgrowth
- Fibroblast heterogeneity remains one of the key factors used to explain the variables response of the gingival tissues to various gingival over-growth-inducing drugs.
We will at some point have patients taking drugs that are linked to gingival overgrowth. It is important that we as providers not only know enough about the drugs to manage their symptoms, but also how to educate the patient and their families on how to manages their signs and symptoms. Especially since OH is such and important risk factor, we will have more of a hand in helping to prevent unnecessary side-effects.