Treatment of phenytoin-induced gingival hyperplasia by electrosurgery

Many medications and combinations of medications are available for the control of epilepsy, but phenytoin continues to be the most effective agent for most patients. A common side effect of this drug is the development of moderate to severe gingival hyperplasia in tooth-bearing areas, which can contribute to problems of function, oral hygiene, appearance, and, eventually, loss of teeth. Excision by conventional means is technically difficult, time-consuming, may be associated with considerable loss of blood, and requires postoperative care, such as periodontal packing, that is impractical if not impossible for many patients, especially the severely mentally handicapped. We have described a technique of gingivectomy using an electrosurgical device in the hospital with the patient under general anesthesia that has produced good results for more than 15 years. This procedure has virtually eliminated the problems of conventional surgical excision with little or no postoperative sequelae.