Gingival hyperplasia, also known as gingival enlargement, is a swelling of the gum tissue (gingiva). Hyperplasia specifically means an increase in the number of cells in the gum tissue. This increase in gingival cells has many different causes, but one of the most common is drug-induced gingival hyperplasia.

What is drug-induced gingival hyperplasia?

Gingival hyperplasia is a condition when the gum tissue becomes enlarged and gingival cells increase in number. First documented in dental literature in 1939 as a side effect of phenytoin, this condition starts with a mild swelling or enlargement that, if left untreated, progresses rapidly. In later stages, the gum tissue may completely cover the crowns of teeth. This makes way for periodontal disease and can create problems with tooth eruption and bite alignment.

There are three types of gingival hyperplasia:

  • Inflammatory enlargement
  • Enlargement associated with systemic diseases or condition
  • Drug-induced

Each one of these has as its main characteristic swelling and inflammation, but the causes may vary.

Inflammatory enlargement

Chronic inflammation of the gingiva causes the gums to enlarge, which leads to a softening.

Exposure to bacteria may start this process of inflammation. The treatment is generally root planing and scaling, with extra attention to oral hygiene.

Systemic diseases

Enlargement associated with systemic diseases or conditions can include anything from pregnancy to lack of vitamin C.

In general, once your doctor resolves the systemic disease or condition, the gingival hyperplasia symptoms will also resolve.

Drug-induced gingival hyperplasia

Drug-induced gingival hyperplasia is exactly that: certain medications cause inflammation of the gum tissue. It is unclear exactly why some people experience drug-induced gingival hyperplasia while others do not. There are some risk factors that appear to contribute to the likelihood of this condition.

  • Genetics: There is some debate as to whether or not genetics plays a role in developing gingival hyperplasia symptoms. It does seem that people with a family history of drug-induced gingival hyperplasia are more likely to develop this condition, but there may be a variety of other factors at play.
  • Dental hygiene: Patients will not develop drug-induced gingival hyperplasia simply because they do not brush their teeth, but poor oral health in general does play a role in both the frequency and severity of this condition.

What medications can cause gingival hyperplasia?

Unfortunately, there are over 20 different drugs that can lead to symptoms. In particular, medications that can cause drug-induced gingival hyperplasia include:

  1. Phenytoin
  2. Phenobarbital