Non-surgical management of amlodipine-induced gingival enlargement

Introduction: Gingival enlargement is a pathologic condition involving enlargement of the keratinized gingiva. Several factors can contribute to gingival enlargement, including calcium channel blockers. In this paper, we report a case of a middle-aged woman with hypertension who was treated for periodontal disease with gingival enlargement after switching her medication from amlodipine. 

Case presentation: A 45-year-old female patient visited the periodontology department of RSGMP Universitas Airlangga complaining of swollen gums. The patient reported that she did not notice when it began, but she was now concerned as they were increasing in size, and it felt painful sometimes since a month ago. Medically, the patient has had hypertension for the past five years (after giving birth to her last child) and has been taking amlodipine 10mg irregularly for the past three years. The patient was diagnosed with moderate generalized chronic periodontitis stage II grade B with drug-induced gingival enlargement. 

Case management: A non-surgical approach was given to the patient, including effective plaque control and reducing, discontinuing, or substituting the suspected medication and local application of antibiotics. 

Conclusion: The optimal treatment approach involves modifying the medication and using conservative periodontal therapy. Surgical intervention should be contemplated solely when the condition fails to respond to alternative therapy. Determining the most effective treatment for each patient and implementing an interdisciplinary approach with collaboration among medical and dental professionals is essential.