Identification of an unidentified corpse with gingival overgrowth: A case report

Drug-induced gingival overgrowth (DIGO) is a common side effect of drugs, such as phenytoin, cyclosporine, and calcium channel blockers, which mainly affect the connective tissue of the gingiva. In some cases, severe gingival enlargement may obscure tooth crowns, which are easily recognizable by clinical internists and dentists. However, there are few reports on personal identification using DIGO and drug analysis. An unidentified Asian woman with a middle-to old-aged appearance was found dead in a river. DIGO was suspected based on the findings of severe gingival overgrowth and the results from liquid chromatography-tandem mass spectrometry, which detected several prescription drugs including a calcium channel blocker, amlodipine. This information led the police to identify potential candidates in nearby hospitals. Prescription and dental records from the investigation confirmed the identity of the deceased. The discovery of gingival overgrowth is an important indication for suspecting the use of calcium channel blockers, anticonvulsants, or immunosuppressants. This case reminds us that not only knowledge of the tooth findings but also of the gingival pathological findings are important for professionals in forensic fields.