Prevalence of gingival overgrowth induced by calcium channel blockers: A community-based study

Background: The prevalence of gingival overgrowth induced by chronic medica tion with calcium channel blockers is uncertain. Although there have been s everal studies examining this question, the results are conflicting, with p revious estimates ranging from 20% to 83%. There have been only 2 studies e xamining the prevalence of overgrowth induced by diltiazem and amlodipine, with estimates of 74% and 3.3%, respectively. Methods: The current study aimed to address the problems associated with th ese studies by examining a sample of patients taking one of 3 calcium chann el blockers, who were drawn from a community-based population in northeaste rn England. Nine hundred eleven (911) subjects were recruited from general medical practices in the area. Of these, 442 were taking nifedipine, 181 am lodipine, and 186 diltiazem. In addition, 102 control subjects were examine d. Drug and demographic data for each subject were recorded. The periodonta l condition of all subjects was assessed including plaque index, papillary bleeding index, and a photograph of the anterior gingivae for subsequent an alysis of overgrowth severity. Results: More than six percent (6.3%) of subjects taking nifedipine were se en to have significant overgrowth. This overgrowth was statistically greate r than the amount of overgrowth seen in either of the other 2 drug groups o r the control population. The prevalence of gingival overgrowth induced by amlodipine or diltiazem was not statistically significant when compared to the control group. The severity of overgrowth within the nifedipine group w as found to be related to the amount of gingival inflammation and also to t he gender of the subject, with males being 3 times as likely to develop ove rgrowth than females. Conclusions: The prevalence of clinically significant overgrowth related to chronic medication with calcium channel blockers is low, i.e., 6.3% for ni fedipine. Males are 3 times as likely as females to develop clinically sign ificant overgrowth. The presence of gingival inflammation is an important c ofactor for the expression of this effect.