Multidisciplinary Management of Phenytoin-Induced Gingival Enlargement: A Case Report

This case report describes a 21-year-old female patient with a history of epilepsy who developed generalized gingival enlargement after 18 months of phenytoin therapy. The patient presented with pain, difficulty in chewing, and esthetic concerns. Clinical examination revealed generalized edematous gingival overgrowth with bleeding on probing, pseudopockets, and subgingival calculus. A multidisciplinary approach was adopted, beginning with consultation with the patient's physician regarding alternative medication. Non-surgical periodontal therapy, including scaling, root planing, and oral hygiene reinforcement, was performed to reduce inflammation. Following improvement in gingival condition, surgical management with an external bevel gingivectomy was carried out. Histopathological evaluation confirmed features consistent with phenytoin-induced gingival enlargement. Postoperative healing was satisfactory, and the patient was maintained on supportive periodontal therapy. This case highlights the importance of multidisciplinary collaboration between physicians and dental professionals in the management of drug-induced gingival enlargement. Comprehensive treatment that integrates pharmacologic modification with periodontal therapy can restore oral health, improve esthetics, and enhance patient confidence and quality of life.