How does phenytoin cause gum hypertrophy?
Phenytoin has been shown to induce gingival overgrowth by its interaction with a subpopulation of sensitive fibroblasts. Cyclosporine has been suggested to affect the metabolic function of fibroblast (eg, collagen synthesis, breakdown).
What is gingival hyperplasia from phenytoin?
Phenytoin-induced gingival overgrowth generally be- gins in the anterior interdental gingival papillae, often within I month after initiation of the drug.” The extent of overgrowth may be related to the dose, duration, and plasma levels of the drug,’ but some studies do not support this concept.
How do anticonvulsants cause gingival hyperplasia?
Drugs like PHT, phenobarbitone, and primidone are metabolized to 5-(4-hydroxyphenyl) 5-phenyl hydantoin (4-HPPH), responsible for overgrowth gingival tissue. At times, multiple anticonvulsants are given together, acting synergistically and aggravating the condition.
Which antiepileptic drug causes gum hypertrophy?
Phenytoin is the drug, which can be chiefly implicated for causing gingival overgrowth. Sodium valproate carries the potential for gingival overgrowth, although only up to clinically insignificant levels in 6 months. Carbamazepine can be considered a safe drug in children in relation to gingival overgrowth.
How can you prevent gingival hyperplasia from phenytoin?
Folic acid supplementation prevents gingival hyperplasia in most children started on phenytoin monotherapy. Phenytoin is an excellent and cost-effective antiepileptic drug (AED) that is especially useful in developing countries with limited access to newer AEDs.
What is the general mechanism of action for antiseizure drugs?
The major mechanism of action of ZNS is reduction of neuronal repetitive firing by blocking sodium channels and preventing neurotransmitter release. It also exerts influence on T-type calcium channels and prevents influx of calcium.
How does nifedipine cause gingival hyperplasia?
The principal action of nifedipine is to inhibit the influx of extracellular calcium ions across the membranes of cardiac and vascular smooth muscle cells, without changing serum calcium concentration (1). One of the side effects of this drug is gingival hyperplasia which was first described in 1984 by Lederman (2).
How does nifedipine cause gingival enlargement?
[2] Various factors were attributed for the overgrowth of gingiva in nifedipine-induced hyperplasia, which include high plaque index (poor oral hygiene), high dose of the drug, genetic factors, individual susceptibility, and interaction between drugs and metabolites with the fibroblasts of gingiva.
What causes gingival hypertrophy?
Gingival hyperplasia can occur as a direct result of inflammation. The inflammation is often caused by plaque buildup on the teeth from food, bacteria, and poor hygiene practices. The inflammation can make the gums tender and red, and it can trigger bleeding.
Is gingival hyperplasia a side effect of phenytoin?
Gingival enlargement is a well-recognized adverse effect and occurs in about 50% of patients receiving phenytoin. [12] As per evidence, drug-induced gingival enlargement may improve by substitution with other anticonvulsant drugs, along with reinforcement of good oral hygiene regimen.
How can you prevent gingival hyperplasia while taking Dilantin?
How does phenytoin work to suppress seizure activity?
Phenytoin is used to control certain type of seizures, and to treat and prevent seizures that may begin during or after surgery to the brain or nervous system. Phenytoin is in a class of medications called anticonvulsants. It works by decreasing abnormal electrical activity in the brain.