Gingival overgrowth and drug association

Abstract

Drugs used locally or systemically induce several micro- and macroscopic tissue alterations. However, nearly 20 drugs have been reported so far in the literature, having association with the gingival enlargement. Many systemic diseases have their limited therapeutic options and such drugs or their metabolites have adverse influence on different systems/organs, and one of such is, they initiate or accelerate the overgrowth of gingival tissue. The over increase in the size of gingiva may be to the extent that, teeth may be partially or completely covered. And the resultant gummy smile may result in esthetic insult of the sufferer. In the presence of bacterial inflammation in gingiva, many of these drugs enhance collagen production by fibroblast cells, and simultaneously retard collagen destruction and hence increase the bulk of gingival tissue. It is apparent that there is subpopulation of fibroblasts those are sensitive to these drugs. The exuberant growth of gingival tissue has great esthetic concern, which may require mechanical removal of bacterial plaque, calculus, and surgical intervention and/or substitution of drug therapy by analogs. Relatively healthy oral environment provided by the dentist will reduce local micro-flora that will help eliminating the major focus of infection. Patient's physicians, general practitioners and dentist need to make coordinated and concise treatment plane to prevent or minimize the overgrowth and will be beneficial for the patients. This article will facilitate full information to physicians and general practitioners to involve dentists in the multidisciplinary treatment plane for these patients.