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Phenytoin gingival hyperplasia — GPhC CRA MCQ

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ModerateAdverse Drug Reactions and SafetyPhenytoin gingival hyperplasiaGPhC CRA

A young adult asks for chlorhexidine mouthwash after starting phenytoin 300mg nightly for epilepsy. He has gum swelling and bleeding when brushing. He has not seen a dentist for 18 months. What is the most appropriate action?

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Correct answer: D — Advise dental review and oral hygiene support because phenytoin can cause gingival overgrowth

Phenytoin can cause gingival hyperplasia, particularly with poor oral hygiene. Dental review and oral hygiene measures are appropriate, while the prescriber may need to review therapy if severe. The patient should not stop antiepileptic treatment abruptly. The presentation does not primarily suggest oral candidiasis or treatment failure.

Reference: BNF