Adverse Effects of Medications on Periodontal Tissues

*Sukumaran Anil, Seham H.S.A. Alyafei, Annie Kitty George and Elna Paul Chalisserry*

#### **Abstract**

Periodontal tissue is susceptible to a range of adverse effects of several medications used in daily medical practice. Phenytoin, cyclosporine, and calcium-channel blockers are the most commonly used drugs related to gingival disease. Several other medications can also have an adverse effect on the periodontium, especially in the presence of compromised oral hygiene. These medications act on periodontal tissues by triggering the inflammatory pathways involved in the pathogenesis of periodontal disease or by potentially compromising the management of patients with these conditions. Gingival overgrowth is probably the mostly widely recognized and investigated type of adverse drug reaction in the periodontal tissues. Since many patients are on such medications, dental practitioner should take a thorough medical history and be aware of medication-related problems and their potential effects on diagnosis and treatment planning. The chapter reviews the commonly prescribed medications that can affect the periodontium either in its healthy or inflamed condition.

**Keywords:** adverse effects, calcium channel blockers, gingival overgrowth, hypertension, anticonvulsants, immunosuppressants

#### **1. Introduction**

Medications are chemical substances used to treat, cure, prevent, or diagnose a disease or to promote well-being. An adverse drug reaction is defined by WHO as a response to a drug which is noxious and unintended, and which occurs at doses normally used in man for the prophylaxis, diagnosis, therapy of diseases or for the modification of physiological function. Several medications can cause adverse effects in the periodontium. The most common are the gingival enlargement, inflammation, pigmentations, gingival bleeding and osteonecrosis [1]. Gingival overgrowth (GO) or enlargement is a condition is characterized by an increase in the size of gingiva subsequent to the increase in extracellular tissue volume. Gingival overgrowth is a side effect of several medications used by patients have the capability to cause adverse effects in the oral cavity and periodontal tissues [2]. Though many medications have marked effects on the periodontal tissues and these adverse reactions are well documented, many have been described only as isolated case series or reports [2]. It is important for the clinician to obtain a complete record of the medications the patient takes, including prescription drugs and over-thecounter drugs. This will help the clinician to diagnose and manage the adverse effects in the periodontal tissues.
