Bisphosphonates . The Food and Drug Administration and Novartis Pharmaceuticals Corporation have each issued a drug precaution for health professionals regarding a condition known as Osteonecrosis of the Jaw (ONJ). According to these precautions, this condition has been observed in cancer patients who undergo invasive dental procedures such as dental implants or tooth extractions while receiving treatment with intravenous bisphosphonates. ONJ can cause severe, irreversible and often debilitating damage to the jaw. The two intravenous bisphosphonates that were mentioned in the precautions are marketed by Novartis under the trade names Aredia and Zometa. Oral forms of this drug include the commonly prescribed medications Fosamax, Boniva and Actonel to name a few. Although the same risk for complications exist with the oral medications, the percentage is far less. A screening test is now available to determine your risk prior to any surgical treatment.
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Immunosuppressants have been associated with gingival enlargement. Cyclosporine is the drug of choice for organ transplant recipients and patients who take this drug are commonly effected.
Calcium channel blockers are commonly prescribed for patients with high blood pressure, angina , and peripheral vascular disease. Gingival enlargement has been associated with patients who are prescribed this family of medications at an incidence of 5-15%. Commonly prescribed medications in this group are Procardia, Norvasc, Cardizem, Caduet, and Calan.
Anticonvulsants are primarily prescribed for patients with epilepsy and other various neurologic seizure disorders. Dilantin has up to a 50% incidence of gingival hyperplasia. Other medications in this group include Phenobarbitol and Tegretol but are rarely associated with ginival hyperplasia(less than 5%).
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