Felodipine‑associated gingival overgrowth in a type 2 diabetic patient: A case report and literature review

Abstract

Gingival overgrowth (GO) includes gingival enlargement and hyperplasia and may be induced by certain drugs, including calcium channel blockers (CCBs), particularly first-generation CCBs. However, to date, only few cases of GO induced by second- or third-generation CCBs have been reported. The present study reports on a case of a 48-year-old diabetic male who was admitted to the First Hospital of Jilin University (Changchun, China) due to poor blood glucose control. This patient was diagnosed with GO. Review of the patient's medical history revealed diagnoses of type 2 diabetes and hypertension, as well as the use of felodipine, a second-generation CCB, to control hypertension. The hypertensive drugs were replaced and the new drugs helped the patient control his blood glucose levels. Additionally, the patient was instructed on methods he could use to improve his oral hygiene, including rinsing of the teeth following each meal and increasing the frequency of tooth brushing per day. After 3 months, the clinical symptoms of GO were relieved. The relevant literature was also reviewed to gain an improved understanding of the correlation between GO and CCBs, as well as diabetes and poor oral hygiene.

Calcium Channel Blockers Induced Gingival Overgrowth

“…Several studies attempted drug discontinuation and/or non-surgical periodontal therapy and reported successful results in terms of management. [ 28 ] A case series published by Routray et al . [ 29 ] in 2003 reported a 15-year-old male taking 5 mg of amlodipine daily for hypertension induced by aortoarteritis.…”

Treatment of calcium channel blocker-induced gingival overgrowth without modifying medication

“…Previous case reports have also mentioned the association between diabetes and the induction of CCB-induced GO 26 27. Although the mechanism by which diabetes mellitus affects GO remains unclear, it has been hypothesised that hyperglycaemia is related to an increased inflammatory response which may play a role in the pathogenesis of GO 28. Additionally, ‘poor oral hygiene’ is a commonly reported factor in several case reports regarding diabetes and the development of GO, including ours, and is a key factor which causes gingival inflammation.…”