Management Of Amlodipine Associated Drug Induced Gingival Enlargement With Non-Surgical Periodontal Therapy - A Case Report

Abstract

Background: Drug-induced gingival enlargement (DIGE), also known as gingival hypertrophy, is a well-documented adversity of certain class of drugs, including anticonvulsants, immunosuppressants, and calcium channel blockers. It manifests as abnormal gingival overgrowth, often leading to functional impairment and esthetic concerns.

Case Report: A 58-year-old female presented in the Outpatient Department of Periodontics, with a chief complaint of generalized swelling of her gingiva for past 1 year associated with episodes of pus discharge in upper left front tooth region. The medical history revealed long-term polypharmacy for myasthenia gravis, systemic hypertension, and diabetes mellitus.

Intervention: The patient underwent a comprehensive evaluation to identify the causative drug. A non-surgical, two-phased periodontal therapy was implemented, including meticulous oral hygiene reinforcement and professional debridement. Coordination with the patient’s physician was undertaken to explore alternative medications to amlodipine.

Results: Following periodontal therapy, a significant reduction in gingival inflammation and enlargement was achieved, with marked improvement in function and oral hygiene. Consideration of alternative antihypertensive therapy was also discussed to minimize recurrence risk.

Conclusion: This case underscores the importance of timely recognition of DIGE, especially in patients on multiple systemic medications. An interdisciplinary approach, combining periodontal therapy with medical consultation for drug substitution, is essential for effective management and prevention of recurrence.