What three types of drugs are associated with gingival hyperplasia?

• A. Anti-convulsants; Immunosuppressants; Calcium channel blockers
• B. Antibiotics; Antivirals; Antifungals
• C. Analgesics; Antihistamines; Diuretics
• D. Anticoagulants; beta-blockers; ACE inhibitors

Answer: (A)

Gingival hyperplasia happens when gingival tissue grows abnormally, and certain drugs are classic triggers. The three drug classes most consistently linked to this condition are anticonvulsants (for example, phenytoin), immunosuppressants (such as cyclosporine), and calcium channel blockers (like nifedipine). These medications influence gingival fibroblasts and the balance of collagen production and degradation, often increasing extracellular matrix formation while reducing its breakdown. The result is fibrous overgrowth of the gums, especially with accompanying plaque and inflammation. Clinically, this can be managed with meticulous oral hygiene and professional cleanings, and, when possible, by coordinating with the prescribing clinician to adjust the medication. Other drug classes listed do not have as strong and consistent an association with gingival overgrowth.