Preventing Enlarged Gums With Substitute Drugs

Most of us are familiar with the swelling and inflammation of the gums from the all too common condition, gingivitis. This relatively innocuous form of gum disease can be easily reversed by improved oral hygiene and a mouth rinse like Listerine®. Less familiar and considerably more difficult to treat is enlargement of the gums (gingival hyperplasia) caused by the side effects of certain medications.

There are three classes of medications that can cause enlarged gums, namely, the anticonvulsants, immunosuppressants and calcium channel blockers. Common examples of these drug classes include Dilantin® (Phenytoin), Procardia® (Nifedipine) and Neoral® (Cyclosporine).

It is important to point out that these drugs have vital medical uses despite their oral and other side effects. Dilantin is used for the treatment of seizure disorders as well as the prevention of seizures following surgery to the brain. Procardia is used to treat high blood pressure, angina (chest pain), cardiac arrhythmias as well as other conditions. Neoral is used alone or in combination with other immunosuppressive drugs to prevent or treat organ rejection after a transplant, and may also be used for rheumatoid arthritis or psoriasis.

Overgrowth of the gums caused by these drugs can have a serious impact on a person's quality of life. Enlarged gums can be esthetically unappealing, and may also impair both speaking and eating. To treat this condition, an oral surgeon must surgically remove the excess gum tissue and then instruct the patient to maintain excellent oral hygiene. The dentist may also prescribe a potent mouth rinse that contains chlorhexidine gluconate (Peridex®). The problem is that even when these measures are taken, the gums will often grow back to their intrusive size again. This cyclical dilemma has proven frustrating to patients and dentists alike.

Recently, two new drugs have come on the market that may be safe substitutes and do not cause nearly as much overgrowth of the gums. The first drug is called DynaCirc® (Isradipine) and may be a safe substitute for the calcium channel blocker Procardia (Nifedipine). The other drug, Prograf® (Tacrolimus), may be a reliable replacement for the immunosuppressant Neoral (Cyclosporine). Unfortunately, there is not presently a substitute drug for the anticonvulsant Dilantin (Phenytoin).

The use of these alternate drugs is something that you may want to discuss with your medical doctor. In some cases, these substitute drugs may not be adequate for your specific medical condition. In other cases, however, your medical doctor may decide that these replacement drugs can effectively treat your disease and also reduce the unwanted side effect of enlargement of the gums.