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Published on: June 28, 2024

Folic acid supplementation prevents phenytoin-induced gingival overgrowth in children

R Arya1, S Gulati, M Kabra

  • 1Division of Pediatric Neurology, AIIMS, Ansari Nagar, New Delhi 110 029, India.

Neurology
|April 13, 2011
PubMed

Insights

Folic acid supplementation significantly reduced phenytoin-induced gingival overgrowth in children with epilepsy. This intervention offers a clinically relevant preventive strategy for this common adverse effect.

Area of Science:

  • Pediatric Neurology
  • Pharmacology
  • Oral Medicine

Background:

  • Phenytoin (PHT) therapy frequently causes gingival overgrowth, affecting approximately 50% of patients.
  • Gingival overgrowth is a significant adverse effect impacting patient quality of life and treatment adherence.

Purpose of the Study:

  • To evaluate the efficacy of oral folic acid supplementation in preventing phenytoin-induced gingival overgrowth (PIGO) in pediatric epilepsy patients.
  • To assess the impact of 0.5 mg/day folic acid on PIGO incidence in children aged 6-15 years on PHT monotherapy.

Main Methods:

  • A randomized, double-blind, placebo-controlled trial involving 120 children (6-15 years) on new PHT monotherapy.
  • Participants received either 0.5 mg/day folic acid or a placebo for six months.
  • The primary outcome was the incidence of any degree of gingival overgrowth after the treatment period.

Main Results:

  • The incidence of PIGO was significantly lower in the folic acid group (21%) compared to the placebo group (88%) (p < 0.001).
  • Folic acid supplementation demonstrated an absolute risk reduction of 67% and a relative risk reduction of 0.76 for PIGO.
  • The two treatment arms were comparable at baseline, ensuring the validity of the results.

Conclusions:

  • Oral folic acid supplementation is an effective and clinically relevant method for decreasing the incidence of PIGO in children receiving PHT monotherapy.
  • This study provides Class I evidence supporting the use of folic acid as a preventive measure against PHT-induced gingival overgrowth.
Abstract

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