Drug induced gingival enlargement Flashcards
What is drug induced gingival enlargment
Increase in size of gingiva
Why might gingival enlargement occur?
Medication
Gingival lesions of genetic origin
What type of pockets may occur due to gingival enlargement
pseudo pocket (increase when probing in pocket depth due to coronal enlargement which may cover part or sometimes all of crown of tooth)
What is hereditary gingival fibromatosis cause by excessiveness of
production of collagen with activated fibroblasts (higher rate of proliferation)
Problems with hereditary gingival fibromatosis, list 3
speech and mastication
aesthetics
plaque control
3 main clinical appearances of gingival enlargements
- generalised papillary swellings
- fibrous appearance
- firm
What clinical features are important to note in gingival enlargement patients?
List 4
- gingival margin in relation to crown and root
- texture
- location
- localised/generalised?
What 3 main medications are known to possible develop drug induced gingival enlargement?
- Calcium channel blockers (hypertension e.g. amlodipine)
- Phenytoin (epilepsy)
- Cyclosporin (used as immunosuppressant following a transplant).
Not every patient who takes certain medications will develop gingival enlargement what can be a factor which is why it may occur
patient has poor OH
gingival enlargement is generally due to an imbalance between ………. degradation and production of …….. ……… and this is due to the inactive collagenase by gingival ………
collagen
tissue matrix
fibroblasts
What is important to focus on with patients who experience gingival enlargement
educating patient on OH - plaque control
If after OHI education still no improvement what else can be a possibility?
Contact GP to see possibility of changing medication.
What 2 types of surgery can be done to help reshape and reduce tissues to help with patients OH
Gingivectomy (removing tissues)
Flap surgery (reshaping/reducing tissues)
