What is gingival overgrowth?

Gingival overgrowth is the enlargement of the gums in the mouth. The condition is usually caused by medications, such as high blood pressure medications or anti-epileptic drugs. There may also be a genetic cause for the enlargement. Other risk factors include gum disease and poor hygiene. A person with gingival overgrowth may have trouble chewing and keeping their teeth clean, as gum tissue grows between the teeth.

The most common causes of gingival overgrowth are calcium channel blockers, used to treat high blood pressure, and phenytoin, and anti-seizure medications used to treat epilepsy. An immunosuppressant, cyclosporine, can also cause enlargement. In some cases, patients may take calcium channel blockers and cyclosporine, further increasing their risk of overgrowth. The overgrowth is usually noticed about a month after the patient starts taking the drug.

When the gums overgrow, the tissue becomes more fibrous. The gums are usually swollen and red. The most commonly affected area of ​​the gums is the interdental papilla, or tissue between the teeth, particularly the papillae between the front teeth.

Gingival overgrowth can be painful and disfiguring. It usually causes the gums to bleed and can cause the teeth to become loose. It can also cause serious problems with speaking and eating, as the shape of the bite changes, making chewing difficult. The condition also often increases the patient's risk of oral infections and periodontal disease.

As the gums grow over the top or crown of the tooth, daily brushing and flossing can become difficult. The overgrowth can lead to cavities, as a patient cannot properly clean their teeth. Although poor hygiene and periodontal disease can lead to overgrowth, enlarged gums can also cause gum disease.

One way to reduce dental problems caused by gingival overgrowth is to have the patient see a dentist four times a year, or every three months, to have the teeth cleaned and plaque removed. At each dental checkup, the patient should be instructed in proper home care. Some patients may find that rinsing with a 0.12 percent chlorhexidine solution also slows the overgrowth.

If the gingival overgrowth is caused by medications, some patients may need to stop the medication to slow the overgrowth. Withdrawal of medication may not be effective for patients who have had gum enlargement for a long period of time. Some medications, such as antibiotics or antifungal medications, can slow down the overgrowth. A 2011 study suggested that folic acid treatment may reduce gingival overgrowth caused by phenytoin.

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