Prevalence of gingival overgrowth induced by antihypertensive drugs: A hospital-based study

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Abstract

Background:

Gingival overgrowth (GO) is a known side-effect of calcium channel blockers. Although there have been several case reports, few studies have examined the prevalence of nifedipine, diltiazem, and amlodipine. This study was conducted to determine the prevalence and risk factors for GO in patients treated with calcium channel blockers.

Materials and Methods:

A cross-sectional study was conducted in out patient Department of Medicine, Government Medical College, Calicut. 133 patients taking antihypertensives were examined for the presence of GO using two different indices: Vertical GO in 6 points around each tooth and horizontal Miranda-Brunet index in the interdental area. Gingival index (GI), plaque index, and probing depth were also evaluated.

Results:

The frequency of GO was significantly higher in nifedipine-treated cases than other drug groups. Frequency of GO was 75% for nifedipine, 31.4% for amlodipine and 25% for amlodipine + metoprolol. Higher gingival, plaque and calculus were observed in patients taking calcium channel blockers. Among the possible risk factors, only the GI showed a significant correlation with GO.

Conclusions:

Patients taking antihypertensives had poor oral hygiene. Patients taking nifedipine showed a higher frequency of GO. Gingival inflammation acts as a predisposing factor.

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Most cited references 19

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PERIODONTAL DISEASE IN PREGNANCY. II. CORRELATION BETWEEN ORAL HYGIENE AND PERIODONTAL CONDTION.

J SILNESS, H Löe (1964)

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Prevalence of gingival overgrowth induced by calcium channel blockers: a community-based study.

J Thomason, J. Douglas Steele, Lisa R Seymour … (1998)

The prevalence of gingival overgrowth induced by chronic medication with calcium channel blockers is uncertain. Although there have been several studies examining this question, the results are conflicting, with previous estimates ranging from 20% to 83%. There have been only 2 studies examining the prevalence of overgrowth induced by diltiazem and amlodipine, with estimates of 74% and 3.3%, respectively. The current study aimed to address the problems associated with these studies by examining a sample of patients taking one of 3 calcium channel blockers, who were drawn from a community-based population in northeastern England. Nine hundred eleven (911) subjects were recruited from general medical practices in the area. Of these, 442 were taking nifedipine, 181 amlodipine, and 186 diltiazem. In addition, 102 control subjects were examined. Drug and demographic data for each subject were recorded. The periodontal condition of all subjects was assessed including plaque index, papillary bleeding index, and a photograph of the anterior gingivae for subsequent analysis of overgrowth severity. More than six percent (6.3%) of subjects taking nifedipine were seen to have significant overgrowth. This overgrowth was statistically greater than the amount of overgrowth seen in either of the other 2 drug groups or the control population. The prevalence of gingival overgrowth induced by amlodipine or diltiazem was not statistically significant when compared to the control group. The severity of overgrowth within the nifedipine group was found to be related to the amount of gingival inflammation and also to the gender of the subject, with males being 3 times as likely to develop overgrowth than females. The prevalence of clinically significant overgrowth related to chronic medication with calcium channel blockers is low, i.e., 6.3% for nifedipine. Males are 3 times as likely as females to develop clinically significant overgrowth. The presence of gingival inflammation is an important cofactor for the expression of this effect.

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Prevalence of amlodipine-related gingival hyperplasia.

Peter Jørgensen (1997)

Calcium channel blockers are known to contribute to gingival hyperplasia. The vast majority of reports discuss patients taking the drug nifedipine. During the past few years a newer calcium channel blocker, amlodipine, has been used with increasing frequency. To date, six cases have been published indicating that amlodipine may also promote gingival hyperplasia; however, no data have been reported regarding the prevalence of this phenomenon. The purpose of this study was to examine a large group of patients taking amlodipine and determine the prevalence of gingival hyperplasia. One hundred fifty dentate patients who had been taking amlodipine, 5 mg per day for at least 6 months, volunteered to undergo a screening examination for gingival hyperplasia. Mild hyperplasia (< 1/3 clinical crown) was found in five patients-a prevalence of 3.3%. This is significantly less (P < .001) than rates reported for patients taking nifedipine, and not significantly different from rates previously reported in control groups of cardiac patients not taking calcium channel blockers. The results from this group of patients indicated that amlodipine, 5 mg per day, did not induce gingival hyperplasia.

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Author and article information

Journal

Journal ID (nlm-ta): J Indian Soc Periodontol

Journal ID (iso-abbrev): J Indian Soc Periodontol

Journal ID (publisher-id): JISP

Title: Journal of Indian Society of Periodontology

Publisher: Medknow Publications & Media Pvt Ltd (India )

ISSN (Print): 0972-124X

ISSN (Electronic): 0975-1580

Publication date (Print): May-Jun 2015

Volume: 19

Issue: 3

Pages: 308-311

Affiliations

[1] Department of Periodontics, KMCT Dental College, Mukkom, Kerala, India

[1 ] Department of Periodontics, Government Dental College, Calicut, Kerala, India

[2 ] Department of Periodontics, Al-Azar Dental College, Thodupuzha, Kerala, India

[3 ] Department of Periodontics, Tatyasaheb Kore Dental College, Kolhapur, Maharashtra, India

Author notes

Address for correspondence: Dr. Saumiya Gopal, Department of Periodontics, KMCT Dental College, Mukkom - 673 602, Kerala, India. E-mail: saumiyagopal@ 123456gmail.com

Article

Publisher ID: JISP-19-308

DOI: 10.4103/0972-124X.153483

PMC ID: 4520117

PubMed ID: 26229273

SO-VID: e95033db-0715-457c-94d0-a1812d88a197

License:

This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Prevalence of gingival overgrowth induced by antihypertensive drugs: A hospital-based study

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Abstract

Background:

Materials and Methods:

Results:

Conclusions:

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Arab Journal of Forensic Sciences & Forensic Medicine (AJFSFM)

Most cited references 19

PERIODONTAL DISEASE IN PREGNANCY. II. CORRELATION BETWEEN ORAL HYGIENE AND PERIODONTAL CONDTION.

Prevalence of gingival overgrowth induced by calcium channel blockers: a community-based study.

Prevalence of amlodipine-related gingival hyperplasia.

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