Why are my gums red and swollen; I floss every day and I see my dentist all the time?!

Why are my gums red and swollen; I floss every day and I see my dentist all the time?!

Sep 19, 2023

I get it, but many patients only start to floss when they know they have a dental appointment coming up and are trying to impress the hygienists. It would be like cutting your own hair just before getting a haircut!

You might have drug-induced gingival hyperplasia?

Gingival hyperplasia is a condition when the gum tissue becomes enlarged and gingival cells increase in numberthis condition starts with a mild swelling or enlargement that, if left untreated, progresses rapidly. In later stages, the gum tissue may completely cover the crowns of teeth.

There are three types of gingival hyperplasia:

  • Inflammatory enlargement
  • Enlargement associated with systemic diseases or condition
  • Drug-induced

Each one of these has as its main characteristic swelling and inflammation, but the causes may vary.

Inflammatory enlargement

Exposure to bacteria found in tartar/calculus and plaque may start this process of inflammation. The treatment is generally root planing and scaling, with extra attention to oral hygiene. And injection of antibiotic granules called Arestin.

Systemic diseases

Enlargement associated with systemic diseases or conditions can include anything from pregnancy to lack of vitamin C.

Drug-induced gingival hyperplasia

Drug-induced gingival hyperplasia is exactly that: certain medications cause inflammation of the gum tissue.

Unfortunately, there are over 20 different drugs that can lead to symptoms. In particular, medications that can cause drug-induced gingival hyperplasia include:

  1. Phenytoin
  2. Phenobarbital
  3. Lamotrigine
  4. Vigabatrin
  5. Ethosuximide
  6. Topiramate
  7. Primidone
  8. Nifedipine
  9. Diltiazem
  10. Amlodipine
  11. Felodipine
  12. Verapamil
  13. Cyclosporine A

Within this, there are three classes of medications that commonly cause drug-induced hyperplasia.


Anticonvulsants (numbers one through seven on the list above) are responsible for approximately 50% of all cases of drug-induced hyperplasia.

These drugs are commonly prescribed to control seizures but are also used for some mental health diagnoses, including bipolar disorder and borderline personality disorder.

Calcium channel blockers

Drugs that treat high blood pressure, regulate heart rhythm, and to relieve some types of chest pain. And to Treat panic attacks, Prevent migraine headaches, and Regulate mood.

Immunosuppressants such as Cyclosporine commonly prescribed to prevent rejection in the case of organ transplants are responsible for over 70% of the cases of drug-induced gingival hyperplasia in children (and between 25 and 30% in adults).

How to treat gingival hyperplasia

In some cases, your doctor can substitute other medications to either reduce the risk of drug-induced gingival hyperplasia or to reduce the severity of it.

When it is not possible to replace medications or stop taking them altogether, there are other drug-induced gingival hyperplasia treatments available.

Full-mouth disinfecting

This treatment’s goal is to rid the mouth of any bacteria that is causing infection and inflammation. Antiseptics are applied multiple times and have been shown to relieve symptoms and stop the progression of the condition.

Root scaling and planing

This treatment is also sometimes known as a deep cleaning treatment for teeth. Your dentist will use specialized tools to remove all plaque and other inflammation-causing debris from all around the teeth, including beneath the gumline.

Surgical options

gingivectomy is a more extreme treatment option. This surgical procedure removes excess gum tissue and allows a dental surgeon to completely smooth and clean any areas of infection or inflammation. This option may be necessary when all other attempts at treatment have been unsuccessful.

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