Gum hypertrophy may be seen in individuals on chronic anticonvulsants and in pregnant patients.
About
- Gum hypertrophy (gingival hyperplasia) is a common exam topic, associated with various systemic conditions and medications.
- Frequently observed in patients on chronic anticonvulsants, such as phenytoin, and may affect oral health.
Aetiology
- Poor oral/dental hygiene: Plaque-induced gingivitis can lead to gum overgrowth.
- Medications: Phenytoin (common in chronic anticonvulsant therapy), Ciclosporin (immunosuppressant), and Nifedipine (calcium channel blocker) are well-known causes.
- Hormonal changes: Pregnancy and oral contraceptive pills may contribute to gum hypertrophy.
- Vitamin deficiency: Scurvy (vitamin C deficiency) may lead to gum swelling and bleeding.
- Haematological disorders: Acute Myeloid Leukemia (AML) can present with gingival hypertrophy.
Clinical Presentation
- Bleeding and tender gums, often worsening with brushing or eating.
- Gum inflammation and visible hypertrophy, which can cause discomfort and aesthetic concerns.
- In severe cases, may interfere with speech or mastication.
Investigations
- Full Blood Count (FBC): Assess for anaemia or abnormal leukocyte levels if haematological disorders, such as leukemia, are suspected.
- Medication history: Review for medications known to cause gingival overgrowth.
Management
- Medication review: Assess the necessity of causative medications and consult with the prescribing physician regarding alternatives if needed.
- Oral hygiene: Emphasize regular dental care, including professional cleaning, as well as effective brushing and flossing techniques.
- Dental evaluation: Referral for dental scaling, root planing, and potential surgical intervention if overgrowth is significant.
- Vitamin supplementation: If scurvy is suspected, vitamin C supplementation may help reduce symptoms.