Certain anticonvulsants, cyclosporine, and a variety of calcium channe
l blockers have been shown to produce clinically and histologically si
milar gingival enlargements in certain susceptible patients. These dru
gs appear to be similar with respect to their pharmacologic mechanism
of action at the cellular level. The primary target tissue is the most
essential difference among them, Therefore it is tempting to speculat
e that these agents may act similarly on a common secondary target tis
sue, such as gingival connective tissue, and cause a hyperplastic resp
onse. This tissue reaction may involve a disturbance of calcium ion in
flux into specific cell populations with a resulting alteration in col
lagen metabolism and other host cell response mechanisms. A connection
between ion exchange, folate uptake, collagenase activation, and bact
erial inflammation may exist. Until a more effective approach can be d
eveloped from future research results, treatment should continue to em
phasize plaque control, professional debridement, and resective gingiv
al procedures to improve function, esthetics, and access for home care
.