Introduction: Calcium antagonists are widely used for the treatment of cardiovascular diseases in the general population. Gingival hyperplasia has been reported in a high number of patients taking this kind of antihypertensive agents, mostly in nifedipine-treated ones. The aim of this study is to display the side effects on oral health of the treatment with calcium antagonists.
Materials and Methods: Articles and studies by various authors and sources were accessed through PubMed and Scopus. Case reports from different countries such as the USA, Japan, India and Germany were thoroughly examined thus proving correspondence between taking calcium antagonists and the aforementioned state of the gingiva.
Results: A higher rate of gingival overgrowth is observed due to high-dose calcium antagonists in comparison to patients taking other types of antihypertensive medications. As the process develops, the papilla enlarges thus involving the marginal and the attached gingiva. The increased tissue is due primarily to connective tissue response rather than cell overgrowth. The interaction of calcium antagonists with epithelial keratinocytes, fibroblasts and collagen may eventually lead to gingival hyperplasia in susceptible individuals. The process is more pronounced in the anterior teeth. Gingival hyperplasia may disrupt everyday activities due to impaired aesthetics, speech and mastication. The discontinuation of the medicament stops the previously observed overgrowth of the gingiva.
Conclusion: Drug-induced gingival overgrowth is one of the most widespread side effects of calcium antagonists. However, our understanding of its pathogenesis is still incomplete. A multifactorial etiology has been suggested including environmental, genetic, immunological and inflammatory agents. A further exploration of the risk factors related to the severity of drug-induced gingival overgrowth may be needed.
