PHENYTOIN-INDUCED GINGIVAL OVERGROWTH - A COMMUNITY-BASED CROSS-SECTIONAL STUDY IN FERRARA, ITALY

A community-based cross-sectional study was carried out in Ferrara, No rthern Italy, to verify the frequency of gingival overgrowth in chroni c phenytoin (PHT) users and the risk factors associated with its devel opment. All subjects taking phenytoin were identified using the comput erized list of drug prescriptions available in the study area. Most of the subjects were interviewed and underwent an oral examination to ev aluate their periodontal condition. The prevalence of gingival enlarge ment in chronic PHT users was about 40%. In our study, sex, age, age a t onset of therapy, treatment duration, and oral hygiene were not sign ificantly associated with the risk of developing gingival overgrowth. A direct relationship with daily dose was found to be an independent r isk factor. Younger age and poorer oral hygiene seemed to predispose t o the severest level of gingival involvement. These results support da ta from experimental studies by suggesting that drug-induced gingival overgrowth is a dose-dependent side effect whose severity could be aff ected by local factors.