Drug-associated gingival enlargement

An increasing number of medications are associated with gingival enlargement. Currently, more than 20 prescription medications are associated with gingival enlargement,(1) and an estimated 5% of the elderly outpatient population in the United States is taking these medications.(2) "Gingival enlargement" or "gingival overgrowth" is the preferred term for all medication-related gingival lesions previously termed "gingival hyperplasia" or "gingival hypertrophy." These earlier terms did not accurately reflect the histologic composition of the pharmacologically modified gingiva. Drugs associated with gingival enlargement can be broadly divided into three categories: anticonvulsants, calcium channel blockers, and immunosuppressants. Although the pharmacologic effect of each of these drugs is different and directed toward various primary target tissues, all of them seem to act similarly on a secondary target tissue, i.e., the gingival connective tissue, causing common clinical and histopathological findings.