A 65 year old female patient presented with c/o swelling and purulent discharge from the lower and upper gums, gradually progressive and burning sensation mouth while eating for one year. She also revealed taking some unknown medicine for sore throat 1 year back. Apart from this she is also complaining of non productive chronic cough for last 3 years. She is non diabetic. Kindly help in diagnosis and management of this case.



Classic case of drug induced gingival enlargement..

Drug induced gingival hyperplasia. Gingivectomy is the treatment.

It is a case of Drug induced gingival enlargement,presence of local factors leading to purulent pus discharge, pseudo pockets.alternative drug regimen with gingivectomy is the treatment.

Drug induced gingival hyperplacia may be antiepilec drugs . Complete blood picture needed for any blood cells changes .

Case of drug induced gingival hyperplasia, take consent from her physician and periodontist for gingivectomy, later on should not ignore local factors too.

Looks Gingival hyperplasia. Psudo pockets -food stagnation- infections-purulent discharge. Severe bleeeding on pressure.. Hormonal ruled out with age. Medications, most probably here -most often  -ciclosporin, immunosuppresent. -phenytoin and other anticonvulsants, -calcium channel blockers. , -antidepressants Uncommonly though. Blood conditions such as acute leukaemia or aplastic anaemia & Applcable Systemic conditions too needs to be ruled out.

Please reffer to a Dentist/ Periodontist for Gingivectomy.

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I agree with @Dr. Narayana S ......... can u plz share something more about sore throat, i.e medicines, history and improvements...... regards

I have asked the patient to get all the prescriptions, investigations done prior on her next visit. Once I get those, will share details.

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Gingival hyperplasia ..drug induced...

Is patient hypertensive,if yes,is she on amlodipine? Thyroid status?..anemia/any bleeding disorder,what about halitosis? Initially, start with chlorhexidine mouthwash, antioxidants thorough prophylaxis..

Sir she is non hypertensive and all the rest investigations are within normal limits including thyroid and blood profile.

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Attention of a periodontist is a must.

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