What are the other Names for this Condition? (Also known as/Synonyms)

• Drug-Induced Gingival Fibrous Nodules
• Medication-Induced Gingival Fibromatosis
• Phenytoin-Induced Gingival Overgrowth (PIGO) 

What is Drug-Induced Gingival Fibromatosis? (Definition/Background Information)

• Drug-Induced Gingival Fibromatosis is a common benign condition of the gums. It is a slow-growing tumor that is caused as a side effect of certain drugs; hence, it is a drug-induced condition
• A painless, nodule-like growth may be observed on either the lower gums or upper gums. The nodular growth(s) may be solitary or multiple. Sometimes, there may be bleeding and ulceration from these benign tumors
• The treatment for Drug-Induced Gingival Fibromatosis is generally provided as:
  • Surgical excision of the growth (if needed)
  • Discontinuing the medication causing the condition
• The prognosis of Drug-Induced Gingival Fibromatosis is excellent with prompt and appropriate treatment 

Who gets Drug-Induced Gingival Fibromatosis? (Age and Sex Distribution)

• Drug-Induced Gingival Fibromatosis has worldwide occurrence; it can occur in individuals of any age
• Mostly the condition is noticed, about 3-months after starting a drug therapy (for various reasons)
• Both males and females can be affected
• There is no ethnic or racial preference for Drug-Induced Gingival Fibromatosis. Hence, it may occur in individuals belonging to any race or ethnic group 

What are the Risk Factors for Drug-Induced Gingival Fibromatosis? (Predisposing Factors)

The key risk factor for Drug-Induced Gingival Fibromatosis is the administration of certain drugs that cause the condition (tumor growth on the gums) as a side effect. The drugs commonly observed to induce this overgrowth include:

• Amlodipine
• Bepridil
• Nimodipine
• Bleomycin
• Nisoldipine
• Diltiazem
• Oxidipine
• Felodipine
• Phenytoin
• Sodium valproate
• Nicardipine
• Verapamil
• Cyclosporine 

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider. 

What are the Causes of Drug-Induced Gingival Fibromatosis? (Etiology)

The causes of Drug-Induced Gingival Fibromatosis are:

• Generally unknown, although it is considered as an adverse reaction to certain medications that are taken for various other reasons
• A family history of Drug-Induced Gingival Fibromatosis

Most commonly, it is the drug phenytoin that causes this benign condition. 

What are the Signs and Symptoms of Drug-Induced Gingival Fibromatosis?

The signs and symptoms of Drug-Induced Gingival Fibromatosis include:

• Growth of tissue on gums - gums of both the upper jaw and lower jaw can be affected
• The growth is typically less than 1 cm in size (along the larger dimension)
• The growth(s) on the gums are normally painless and slow
• The solid masses are usually firm to touch and well-defined
• They may be present as well-defined, single or multiple nodules, at different locations on the gums
• Drug-Induced Gingival Fibromatosis may also cause:
  • Bleeding from gums
  • Gum ulceration 

How is Drug-Induced Gingival Fibromatosis Diagnosed?

The following are the diagnostic tools for Drug-Induced Gingival Fibromatosis:

• A thorough physical examination and a complete medical history are very crucial factors
• A tissue biopsy of the tumor: A tissue biopsy is performed and sent to a laboratory for a pathological examination. A pathologist examines the biopsy under a microscope. After putting together the clinical findings, special studies on tissues (if needed) and with microscope findings, the pathologist arrives at a definitive diagnosis. Examination of the biopsy under a microscope by a pathologist is considered to be the gold standard, in arriving at a conclusive diagnosis
• Sometimes, the pathologist may perform special studies, which may include immunohistochemical stains, histochemical stains, molecular testing, and very rarely, electron microscopic studies
• Differential diagnosis, to eliminate other tumor types are often considered, before arriving at a definitive diagnosis

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis. 

What are the possible Complications of Drug-Induced Gingival Fibromatosis?

No significant complications due to Drug-Induced Gingival Fibromatosis have been reported. However, the following may occur:

• Occasionally, the tumor may become large in size, resulting in cosmetic issues
• In some cases, gum infections due to ulceration of large tumors may be seen
• The condition may recur after surgical excision, if the tumors are incompletely removed 

How is Drug-Induced Gingival Fibromatosis Treated?

The following are the methods used to treat Drug-Induced Gingival Fibromatosis:

• In most cases, stoppage of the drug causing the condition will cure the condition
• Since, Drug-Induced Gingival Fibromatosis affects the gums, it may cause cosmetic issues. Hence, they may be surgically removed
• Some growths are self-limiting and asymptomatic. These may not require any treatment or surgery; in some cases, they may even regress completely
• Follow-up care with regular screening and check-ups are important to monitor the condition

The healthcare provider shall determine the best course of treatment, depending on each individual’s circumstance. 

How can Drug-Induced Gingival Fibromatosis be Prevented?

Following is the information for prevention of Drug-Induced Gingival Fibromatosis:

• Currently, there are no specific methods or guidelines to prevent Drug-Induced Gingival Fibromatosis oral condition
• Stopping the drug causing the condition, as early as possible is important
• Early diagnosis with close monitoring and treatment of the condition is also important 

What is the Prognosis of Drug-Induced Gingival Fibromatosis? (Outcomes/Resolutions)

• The prognosis of Drug-Induced Gingival Fibromatosis is very good with treatment
• Prompt treatment and early recognition will help in arriving at an optimal outcome 

Additional and Relevant Useful Information for Drug-Induced Gingival Fibromatosis:

• Hereditary gingival fibromatosis (HGF) is a common, slowly-progressing, benign condition of the gums. This condition has been noted to be present from birth 

The following article link will help you understand hereditary gingival fibromatosis.

http://www.dovemed.com/diseases-conditions/hereditary-gingival-fibromatosis/