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KMID : 1144020200160010035
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Journal of Korean Association for Disability and Oral Health
2020 Volume.16 No. 1 p.35 ~ p.47
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Dental management of gingival overgrowth in children on antiepileptic drug therapy: Case reports
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Lee Mi-So
Kim Jea-Gon
Yang Yeon-Mi
Lee Dae-Woo
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Abstract
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Anticonvulsants commonly used as a treatment for epilepsy frequently cause undesired gingival enlargement. Phenytoin is the most well-known anticonvulsant that induces gingival enlargement. As an alternative, sodium valproate can be considered; it is used less frequently but can also cause gingival enlargement. We present case reports of two patients that experienced druginduced gingival enlargement due to anticonvulsants.
The first case was a 13-year-old girl who was referred for gingival enlargement. She had Lennox-Gastaut syndrome and was taking anticonvulsants. The gingiva of her entire dentition was overgrown and completely covered the crowns of all teeth. After a gingivectomy under general anesthesia, the gingival enlargement improved, but severe-to-moderate gingival enlargement remained due to need for continued treatment for intractable epilepsy.
The second case was an 11-year-old boy who was diagnosed with pachygyria scoliosis and had been taking sodium valproate. He had severe generalized fibrous drug-induced gingival enlargement with poor oral hygiene. The gingival status did not improve remarkably despite regular intensive professional tooth cleaning, but the pathological changes of teeth and gingiva did not progress significantly for at least 3 years.
In conclusion, when gingival enlargement is induced by anticonvulsants, changing the medication should first be considered and adapted, if possible. It is very important for patients to undergo regular checkups and professional tooth cleaning and for guardians to adhere to oral hygiene instruction to improve oral status.
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KEYWORD
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Dental management, Gingival enlargement, Anticonvulsants, Phenytoin, Sodium valproate
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