The wonders of modern medicine allow a huge variety of physical ails to be treated, and managed, which otherwise would severely limit quality of life.
Medicinal intervention comes at a cost though, in the form of side effects. These side effects don’t stop in the mouth.
For this reason today I’ll be discussing drug induced oral disorders:
Anticonvulsants, calcium channel blocking agents, and cyclosporine may all be associated with gingival enlargement. Oral contraceptives may also be a contributing factor in alterations of gingival tissues.
Treatment considerations for patients affected by drug-induced periodontal disease may include:
1. Consultation with patient’s physician as necessary.
2. When possible, baseline periodontal evaluation prior to initiation or modification of drug therapy.
3. Modification of the drug regimen prescribed in consultation with the physician if gingival enlargement or other adverse drug reactions or side effects occur.
4. Surgery as necessary to eliminate gingival enlargement. Patients should be informed that gingival enlargement may recur if drug therapy can not be modified or if adequate plaque control is not achieved and maintained.
I’d also like to mention hematologic disorders and leukemia:
Hemorrhagic gingival enlargement with or without necrosis is a common early manifestation of acute leukaemia.
Patients with chronic leukaemia may experience similar but less severe periodontal changes.
Chemotherapy or therapy associated with bone marrow transplantation may also adversely affect the gingiva, and considerations for patients with hematologic disorders and periodontal disease should include:
1. Coordination of treatment with the patient’s physician.
2. Minimization of sites of periodontal infection by means of appropriate periodontal therapy prior to the treatment of leukaemia and/or transplantation.
3. Avoidance of elective periodontal therapy during periods of exacerbation of the malignancy or during active phases of chemotherapy.
4. Consideration of antimicrobial therapy for emergency periodontal treatment when granulocyte counts are low.
5. Monitoring for evidence of host-versus-graft disease and of drug-induced gingival overgrowth following bone marrow transplantation.
6. Periodontal therapy, including surgery, for patients with stable, chronic leukaemia.
If you treat patients experiencing any of the symptoms mentioned in this article, Biterite would love to hear from you.
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