Calcium Channel Blockers-Induced Gingival Enlargements: Pathogenic Mechanisms, Clinical Findings, and Management

This review aims to provide an update on the gingival enlargement resulting as a side effect of calcium channel blockers, which are widely used in the treatment of cardiovascular diseases. The underlying mechanisms, risk factors, clinical features, and treatment approaches for calcium channel blocker-induced gingival enlargement are outlined.

The pathogenic mechanism of drug-induced gingival enlargement is multifactorial, and still needs further clarification. Microbial dental plaque accumulation, predisposing factors, age, and the duration of medication play roles in the clinical manifestations. For successful management, local etiological factors should be eliminated, patients should be motivated and instructed on optimal oral hygiene. Moreover, consulting with the physician for any possible change in the medication is recommended.

Gingival enlargements are prevalent in dental practice. One of the drug groups that can cause this clinical condition is the dihydropyridine class of calcium channel blockers. Given the widespread use of these drugs in the general population, the side effects on the gingiva can have severe consequences for the patients and clinicians. Management highly depends on patient’s home care and there is a significant risk of recurrence. Maintenance of satisfactory clinical outcomes requires close collaboration between the dentist, the patient, and the physician along with diligent follow-up after completion of active periodontal treatment.