Assessment of Awareness among Physicians Regarding Gingival Overgrowth Induced by Anticonvulsant, Calcium Channel Blocker, and Immunosuppressant Therapy

Abstract

Introduction: Drug Induced Gingival Overgrowth (DIGO) is caused due to prolonged use of anti-convulsants, immunosuppressant, and calcium channel blockers given for non dental purpose. It affects the maintenance of oral hygiene and may cause speech, mastication, tooth eruption and aesthetic problems. General physicians can play a key role as they can inform the patient about gingival overgrowth as an adverse effect of these drugs. Aim: To evaluate the awareness regarding drug induced gingival overgrowth and to know the impact of educational qualification on their awareness among physicians. Materials and Methods: This cross-sectional questionnaire survey was conducted from January 2019 to June 2019 in Latur district of Maharashtra, India. A total of 196 practicing physicians were approached with self-structured questionnaire and answers were collected in the presence of the investigator. Survey responses were divided into two groups based on educational qualification as group A: physicians educationally qualified to practice Allopathy, group B: physicians educationally qualified to practice alternative medicine (Ayurveda, Homeopathy etc.,). Comparison of responses for qualitative variables was carried among groups using Chi square test with p-value set as p<0.05 significant. Results: Total 167 (85.20%) general physicians responded willingly and completed the questionnaire. A total of 129 participants were male, and 38 were female, with age ranging from 27 to 61 years. Among total 88.62%, 34.73%, 43.11% of the physicians knew about adverse effect of antiepileptic, antihypertensive, immunosuppressant drug as gingival overgrowth respectively. Around 50.89% physicians’ check the gingival status of their patients and 21.56% refer their patients to dental practitioners for signs and treatment of gingival overgrowth. Overall, 77.25% of participants said that surgical excision with drug substitution should be the line of treatment for these cases. Statistically significant difference was seen on comparative analysis of responses between group A and group B (p<0.05). Conclusion: The findings of the present study showed that even though physicians know about drug induced gingival overgrowth they were unable to mention the accountable drug. Only few of them check gingival status of patients taking these drugs during follow up visits and refer such patients to dental practitioners. Although physicians qualified in allopathy have more knowledge about these drugs, their approach towards this condition was somewhat similar to the physicians qualified in alternative medicine.