Drug-induced gingival enlargement – Oral implications for prescribing physicians

A male patient presented with a main complaint of persistent growth of the upper and lower gingiva that bled easily and resulted in an inability of maintaining proper oral hygiene. He reports that the growth of the gingiva started approximately three years prior to consultation in our clinic and is asymptomatic. His medical history revealed that he suffers from epilepsy and was being treated with a daily anticonvulsant, namely Phenytoin (100mg). Full-mouth non-surgical periodontal therapy was performed and supplemented with an adjunctive chlorhexidine mouth rinse as a chemical plaque control mechanism. Part of the systemic phaseof management of the patient, involved requesting the medical physician change the current epilepsy medication to Epilim®, which was benefi cial in contributing to the resolution of gingival enlargement. Signifi cant reduction in gingival infl ammation and enlargement were achieved with the non-surgical treatment.Corrective surgery therapy was performed to treat those areas of DIGE that had not resolved.