Association of drug-induced gingival enlargement (calcium channel blockers) and local factors: Who is the culprit?

Background: Several drugs are used for the management of hypertension. Among these drugs, calcium channel blockers (CCBs) are the most potent and generally used drug. Gingival enlargement is a recognized outcome of the administration of CCBs. Other drugs which cause gingival enlargement are antiepileptic drugs (phenytoin) and immunosuppressants (cyclosporine). The role of bacterial plaque in the overall pathogenesis of drug-induced gingival enlargement is not clear as some studies indicate that plaque is a prerequisite for gingival enlargement, whereas others suggest that the presence of plaque is a result of its accumulation caused by the enlarged gingiva. Aim: The aim of this study is to find the association of local factors with CCBs-induced gingival enlargement. Conclusion: The observations made in this report support that the presence of local factors augments the degree of the gingival enlargement present. Significance: As the prevalence of CCB use is relatively high in the population, especially among patients with cardiovascular disease, it is important that medical professionals are aware of the association between drug-induced gingival enlargement and local factors so that they can emphasize thorough home care and professional cleaning in the treatment of drug-induced gingival enlargement.