Which oral health outcome is commonly associated with long-term Dilantin use?

• A. Gingival Hyperplasia
• B. Tooth Whitening
• C. Decreased Salivation
• D. Increased Cavity Resistance

Answer: (A)

Long-term use of phenytoin (Dilantin) is classically linked to gingival hyperplasia. The drug stimulates gingival fibroblasts and alters collagen turnover, so gum tissue grows thicker and can become fibrous and swollen, especially in the front of the mouth. Poor oral hygiene makes the overgrowth worse, creating a cycle where plaque collects in the enlarged gums and further enlargement occurs. Clinically, this presents as swollen, firm gums that may bleed with brushing and flossing and can interfere with cleaning and tooth alignment. Management focuses on meticulous oral hygiene, regular dental cleanings, and coordinating with the physician about seizure control and potential therapy adjustments; in severe cases, surgical reduction of the excess gum tissue may be needed. Other options—such as tooth whitening, decreased saliva, or increased resistance to cavities—don’t fit the typical effects of long-term phenytoin use.