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Drug-Induced Gingival Hyperplasia Treatment & Management

  • Author: Lina M Mejia, DDS, MPH; Chief Editor: William D James, MD  more...
 
Updated: Sep 29, 2014
 

Medical Care

For dental care, refer patients to a general dentist and/or oral medicine specialist for evaluation.

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Surgical Care

Gingivectomy with carbon dioxide or Nd:YAG laser is recommended for patients who have moderate-to-severe gingival enlargement that does not resolve when the dose is reduced, proper oral hygiene is maintained, or after a short course of antibiotics.

Diode laser has also been used for drug-induced gingival hyperplasia,[32] and low level laser therapy has been suggested as adjuvant in the management of this condition.[33]

In the majority of patients for whom drug discontinuation or substitution is not possible and for whom prophylactic measures have failed, surgical excision of gingival tissue remains the only treatment option. At present, the more conservative internal beveled gingivectomy is favored over the conventional gingivectomy in the majority of cases, owing to the predictable healing and better esthetics.[11, 34]

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Consultations

For evaluation and treatment planning, refer patients to a dental practitioner and/or an oral medicine specialist familiar with the oral care of medically complex patients.

An oral medicine specialist and a periodontist should monitor patients with gingival overgrowth for as long as they receive therapy with cyclosporine, phenytoin, or calcium channel blockers to evaluate and treat oral complications from medical therapy.

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Diet

No diet restrictions are recommended for patients with gingival overgrowth other than minimizing the consumption of sweets, starch, soft drinks, and simple carbohydrates.

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Activity

No activity restrictions are reported.

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Contributor Information and Disclosures
Author

Lina M Mejia, DDS, MPH Assistant Professor, Oral Medicine and Diagnostic Sciences, Nova Southeastern University College of Dental Medicine

Lina M Mejia, DDS, MPH is a member of the following medical societies: American Academy of Oral Medicine, American Dental Association, California Dental Association

Disclosure: Nothing to disclose.

Coauthor(s)

Francina Lozada-Nur, DDS, MS, MPH Professor Clinical Oral Medicine (Emerita), University of California at San Francisco School of Dentistry

Francina Lozada-Nur, DDS, MS, MPH is a member of the following medical societies: American Academy of Oral Medicine

Disclosure: Nothing to disclose.

Specialty Editor Board

David F Butler, MD Section Chief of Dermatology, Central Texas Veterans Healthcare System; Professor of Dermatology, Texas A&M University College of Medicine; Founding Chair, Department of Dermatology, Scott and White Clinic

David F Butler, MD is a member of the following medical societies: American Medical Association, Alpha Omega Alpha, Association of Military Dermatologists, American Academy of Dermatology, American Society for Dermatologic Surgery, American Society for MOHS Surgery, Phi Beta Kappa

Disclosure: Nothing to disclose.

Drore Eisen, MD, DDS Consulting Staff, Department of Dermatology, Dermatology Research Associates of Cincinnati

Drore Eisen, MD, DDS is a member of the following medical societies: American Academy of Dermatology, American Academy of Oral Medicine, American Dental Association

Disclosure: Nothing to disclose.

Chief Editor

William D James, MD Paul R Gross Professor of Dermatology, Vice-Chairman, Residency Program Director, Department of Dermatology, University of Pennsylvania School of Medicine

William D James, MD is a member of the following medical societies: American Academy of Dermatology, Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Additional Contributors

Franklin Flowers, MD Department of Dermatology, Professor Emeritus Affiliate Associate Professor of Pathology, University of Florida College of Medicine

Franklin Flowers, MD is a member of the following medical societies: American College of Mohs Surgery

Disclosure: Nothing to disclose.

Acknowledgements

The authors and editors of Medscape Reference gratefully acknowledge the contributions of previous author, Piamkamon Vacharotayangul, DDS, PhD, to the development and writing of this article.

References
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Swelling of the gingival mucosa around the right lower canine and multiple areas of erythema, erosions, and bleeding throughout the upper gingival mucosa.
Enlarged upper and lower gingival mucosa in a partially edentulous patient. Notice how the overgrown tissue tends to engulf the teeth. Poor oral hygiene and poor dentition are the most likely contributing factors in this patient receiving immunosuppressive therapy.
A palatal view of same patient as in Image 2. Notice the severity of the gingival enlargement. If left untreated, patients develop severe periodontal disease and lose teeth.
 
 
 
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