Phenytoin induced gingival overgrowth in institutionalized epileptics

Hassell, Thomas M.; O'Donnell, Joseph; Pearlman, Joel; Tesini, David A.; Murphy, Terry; Best, Henry

doi:10.1111/j.1600-051x.1984.tb02214.x

Cited by 63 publications

(31 citation statements)

References 40 publications

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“…Our findings are in concordance with previous reports that gingival hypertrophy occurs in -30-50% of dentate patients receiving PHT phenytoin therapy (1,2). The incidence and severity of overgrowth does not depend on PHT dosage, serum concentration, or the patient's age or sex but can resolve if the drug is discontinued or replaced (20). Poor oral hygiene has been shown to be an important determinant of PHT-induced gingival changes (2).…”

Section: Discussionmentioning

confidence: 99%

Oral Health and Dental Treatment Needs in Nigerian Patients with Epilepsy

1998

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Summary: Purpose:We determined the prevalence of oral disorders and the dental treatment needs of outpatients with epilepsy.Methods: A questionnaire was administered to 56 consecutive patients (35 males, 21 females) presenting to an outpatient clinic. All patients underwent dental examinations. The clinical and diagnostic features of each patient's epilepsy were also obtained. Results:The mean age (&SD) of the patients was 25.1 k 12.1 years (range, 12-56 years). Of 9 patients receiving phenytoin (PHT) monotherapy, 3 (33.3%) had gingival hypertrophy; 15 of 18 (83.3%) patients receiving PHT in combination with phenobarbital (PB) manifested the disorder. Traumatized anterior teeth were found in 26 (46.4%) patients with the males significantly more affected than females (p = 0.02). When the dental treatment needs were considered, 24 (42.9%) patients required dental prophylaxis with oral hygiene instruction, and an equal number required various types of restorative treatments. Only 13 patients (23.2%) had previously visited a dental clinic; the 43 (76.8%) who had never sought dental treatment claimed they did not see any need for it.Conclusions: Our study showed an increased predilection to anterior dental injuries in patients with epilepsy as compared with the prevalence earlier reported for those without epilepsy in Nigeria (p = 0.00). There is a clear need for effective interaction between medical and dental practitioners in the management of epilepsy.

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Section: Discussionmentioning

confidence: 99%

Oral Health and Dental Treatment Needs in Nigerian Patients with Epilepsy

1998

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“…5 It has been suggested that earlier high prevalence figures may be due to a focus on institutionalized and/or hospital neurology out-patient populations. 6 The incidence and severity of overgrowth is greatest on the labial surfaces of the maxillary and mandibular anterior teeth. Figure 3a shows a variation in the clinical appearance of phenytoin-induced gingival overgrowth compared with other va ri ations of drug-induced gi n gi va l overgrowths ( Fig.…”

Section: Gingival Overgrowthmentioning

confidence: 99%

A clinical review of drug‐induced gingival overgrowths

Marshall

Bartold

1999

Australian Dental Journal

126

139

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There is an increasing number of medications associated with gingival overgrowth. These medications are used to treat a number of common conditions in the Australian population and as such dentists can expect to manage a number of patients with medication-related gingival overgrowth. This review highlights the clinical features and management of the common overgrowths associated with anticonvulsants, immunosuppressants and the calcium channel blockers.

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“…[19][20][21]53 A relationship between oral breathing patterns and gingival overgrowth was not observed in the present study, but it has been reported in patients treated with phenytoin. 7,75 It has been shown that nifedipine-induced gingival enlargement may be reduced or prevented by good plaque control, aimed at reducing gingival inflammation, and that in the most severe cases, resective periodontal surgery is used to eliminate excess tissue. [76][77][78][79][80] Also, wherever possible, reducing the drug dose or replacing it with another agent should be considered.…”

Section: Periodontal Evaluation Of Control and Nifedipine-treated Patmentioning

confidence: 99%

Prevalence and Risk of Gingival Enlargement in Patients Treated With Nifedipine

Miranda

Brunet

Roset

et al. 2001

Journal of Periodontology

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Background: Gingival enlargement is a known side effect of nifedipine use. This study was conducted to determine the prevalence and risk factors for gingival enlargement in nifedipinetreated patients.Methods: A cross-sectional study was conducted in a primary care center. Data from 65 patients taking nifedipine were compared with 147 controls who had never received the drug. All patients were examined for the presence of gingival enlargement using 2 different indices: vertical gingival overgrowth index (GO) in 6 points around each tooth, and horizontal MB index in the interdental area. Gingival index, plaque index, and probing depth were also evaluated.Results: The prevalence of gingival enlargement was significantly higher in nifedipine-treated cases than in controls (GO index, 33.8% versus 4.1%; MB index, 50.8% versus 7.5%, respectively). Higher gingival and plaque indices were observed in patients taking nifedipine. Among the possible risk factors, only the gingival index showed a significant association with gingival enlargement. The risk (odds ratio [OR]) of gingival enlargement associated with nifedipine therapy was 10.6 (3.8-29.1) for the GO index and 14.4 (6-34.6) for the MB index. Gingival index-adjusted ORs were 9.6 (3.3-28.1) and 9.7 (3.9-23.3), respectively. In the subset of high nifedipine exposure patients, the odds ratio for gingival enlargement increased to 17.4 (5.3-56.3) for the 3) for the MB index. The concordance between GO and MB indices showed a kappa value of 0.689 in controls and 0.642 in patients treated with nifedipine.Conclusions: Patients taking nifedipine are at high risk for gingival enlargement, and gingivitis acts as a predisposing factor. J Periodontol 2001;72:605-611.

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Phenytoin induced gingival overgrowth in institutionalized epileptics

Cited by 63 publications

References 40 publications

Oral Health and Dental Treatment Needs in Nigerian Patients with Epilepsy

Oral Health and Dental Treatment Needs in Nigerian Patients with Epilepsy

A clinical review of drug‐induced gingival overgrowths

Prevalence and Risk of Gingival Enlargement in Patients Treated With Nifedipine

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