Interdisciplinary approach in the management of medically compromised patient with drug-induced gingival enlargement

Abstract

Drug-induced gingival overgrowth (DIGO) is one of the most common side effects of three important groups of drugs such as anticonvulsants, calcium channel blockers, and immunosuppressants. Calcium channel blockers are the important group of drugs in the management of cardiovascular diseases; however, they are associated with certain side effects such as DIGO in susceptible individuals. Nifedipine is the frequently involved drug; however, there are few cases of amlodipine-induced gingival enlargement as well. The case reported here is a 55-year-old medically compromised male patient on polypharmacy. Based on the clinical, radiographic investigations and medical history, he was diagnosed as having drug-induced gingival enlargement with chronic generalized periodontitis. The case was managed by nonsurgical periodontal therapy alone in addition to interdisciplinary approach and strict supportive periodontal therapy, which resulted in complete resolution of the gingival enlargement with restoration of normal gingival health.