Prevalence of Gingival Hyperplasia Induced by Anticonvulsants: A Systematic Review

Abstract

Objective: Gingival hyperplasia (GH) is one of the side effects of anticonvulsant drugs. The aim of this study was to verify the prevalence of GH associated with the use of anticonvulsant, through a systematic review. Material and Methods: Systematic search was done at databases Pubmed and Embase between January 1984 and March of 2020 for identification of articles addressing the prevalence of GH associated with the use of anticonvulsant drugs. The methodological index for non-randomized studies (MINORS) was independently assessed for quality in the selected papers. Results: The search identified 4.471 references. Nine articles were selected and evaluated 632 participants. All of the studies included in the systematic review showed a low risk of bias. The anticonvulsants used by patients were carbamazepine, ethosuximide, phenytoin, primidone, phenobarbital, sodium valproate. The studies showed a correlation between different types of anticonvulsants and GH prevalence, with a range from 0% to 73%. Among the anticonvulsants used, phenytoin showed the greatest incidence of GH, varying between 15.61% and 73% in patients. Conclusion: In the analysis of the results obtained in the literature, it is possible to notice that the great majority of studies presented incidence of GH associated with anticonvulsant use. However, further studies are necessary to understand the anticonvulsant action mechanism inducing GH, as well as the prevention forms, given that GH is a significant side effect. KEYWORDS Anticonvulsants; Gingival hyperplasia; Prevalence.

Gingival hyperplasia treatment using diode laser gingivectomy in a child with cerebral palsy: case report

“…One year after starting the use of phenytoin, the first article considering gingival enlargement as an adverse effect of the use of this class of medication was published (Kimball, 1939). On the other hand, in a systematic review, the authors concluded that phenytoin is the drug that causes the highest prevalence of GH in patients who use it (Cláudio, et al, 2021). The pathogenesis of this condition depends on several factors, including the quality of plaque control, gingival inflammation, age, sex, duration of therapy, concentration of drug used, concomitant use of some medications, and genetic factors (Nakib, et al, 2011).…”

“…A previous study showed that phenytoin used for the treatment of epilepsy induced gingival growth in about 50% of patients (Tan, et al, 2004), although some patients did not present excessive gingival growth. Nevertheless, some authors have reported that the occurrence of GH caused by phenytoin is 40 to 50% (Kimball, 1939;Annegers, 1997;Cláudio, et al, 2021).…”

Negative Impacts of Psychiatric Medications on Oral Health: A Literature Review

“…Adjunctive mood stabilizer (i.e., lithium) and anticonvulsant (i.e., sodium valproate) agents could be used [ 35 , 36 ]. Adjunctive mood stabilizer agents affect negatively maintaining oral health care as they produce xerostomia and gingival enlargement, which increase the risk of dental caries and complicate maintaining good oral hygiene [ 37 ].…”