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Calcium Antagonist-Induced Gingival Hyperplasia
- Ruth M. Steele, PharmD;
- Arthur A. Schuna, MS, RPh; and
- Ronald T. Schreiber, MD
- From William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin. Requests for Reprints: Ruth M. Steele, PharmD, Department of Pharmacy, Cook County Hospital, 1900 West Polk, Suite 552, Chicago, IL 60612. Acknowledgments: The authors thank John Tsunehiro, DDS, William Ricks, DDS, and Greg Paprocki, DDS, of the Department of Dentistry at William S. Middleton Memorial Veterans Hospital for their technical support and the Department of Veterans Affairs Research Service for editorial assistance.
The use of calcium antagonists has been associated with gingival tissue overgrowth [1, 2], with reported prevalences varying as follows: 0.5% to 83% for nifedipine [3, 4], 74% for diltiazem [3], and 4% for verapamil [5].
Our study was done to determine the prevalence of gingival overgrowth in patients whose only known risk factor was ingestion of a calcium antagonist and to identify differences in prevalence among patients receiving diltiazem, verapamil, and nifedipine.
Methods
Our evaluator-blinded, case–control, cross-sectional study was done in the hypertension, general medicine, and geriatric outpatient clinics at the Veterans Affairs Hospital in Madison, Wisconsin, from November 1991 to June 1992. All patients taking a calcium antagonist for a minimum of 3 months were eligible for enrollment and were identified from a computer-generated list. These patients were classified into three groups according to drug regimen (nifedipine, verapamil, or diltiazem) and compared with a control group selected from the same clinics that did not receive a calcium antagonist. Exclusion criteria included edentia, calcium antagonist therapy lasting less than 3 months, a history of gingival overgrowth before calcium antagonist treatment, the use of other agents associated with gingival overgrowth (for example, phenytoin or cyclosporine), or a requirement for antibiotic prophylaxis before dental procedures.
After informed consent was obtained, gingival tissue was measured …
