Diphenylhydantoin Induced Severe Gingival Hyperplasia

Abstract

Gingival overgrowth (GO) is a side effect, associated with some distinct classes of drugs, such as anticonvulsants, immunosuppressant, and calcium channel blockers. One of the main drugs associated with GO is the antiepileptic, diphenylhydantoin (DPH)/ phenytoin (1), which affects gingival tissues by altering extracellular matrix metabolism. Phenytoin (DPH)-induced gingival overgrowth (PIGO) due to chronic administration remains an unsolved problem especially in cases where this drug is taken without any supervision due usually to poor follow-up. Younger age groups experience more lesions than adults and in the mentally handicapped the prevalence appears to be highest. The most satisfactory treatment is the replacement of the drug by a safer antiepileptic. Patients who are to be maintained on DPH respond well to a program of meticulous oral hygiene at home along with frequent professional prophylaxes. We present a case of seizure disorder with mental retardation who developed severe gingival overgrowth wherein teeth are almost buried, caused by unsupervised intake of phenytoin. JMS 2017; 20(1):44-46