Felodipine-associated gingival overgrowth in a type 2 diabetic patient: A case report and literature review

Abstract

Gingival overgrowth (GO) includes gingival enlargement and hyperplasia and may be induced by certain drugs, including calcium channel blockers (CCBs), particularly first-generation CCBs. However, to date, only few cases of GO induced by second- or third-generation CCBs have been reported. The present study reports on a case of a 48-year-old diabetic male who was admitted to the First Hospital of Jilin University (Changchun, China) due to poor blood glucose control. This patient was diagnosed with GO. Review of the patient's medical history revealed diagnoses of type 2 diabetes and hypertension, as well as the use of felodipine, a second-generation CCB, to control hypertension. The hypertensive drugs were replaced and the new drugs helped the patient control his blood glucose levels. Additionally, the patient was instructed on methods he could use to improve his oral hygiene, including rinsing of the teeth following each meal and increasing the frequency of tooth brushing per day. After 3 months, the clinical symptoms of GO were relieved. The relevant literature was also reviewed to gain an improved understanding of the correlation between GO and CCBs, as well as diabetes and poor oral hygiene.

Keywords: calcium channel blocker; drug-induced gingival overgrowth; felodipine.

Figure 1.

At presentation, all of the patient's teeth were dark brown due to poor oral hygiene. Oral examination revealed a mouth opening index of III and gingival overgrowth throughout all quadrants that was particularly pronounced under the dental papilla.

Figure 2.

The quality of the patient's teeth was improved after 3 months under the new treatment, although the gingival overgrowth had not been completely eliminated.