Vol. 11 No. 5 (2025): May
Open Access
Peer Reviewed

Case Report of Drug-Induced Gingival Overgrowth (DIGO) in Amlodipine User at Bhayangkara Brimob Hospital

Authors

Rike Rayanti , Sylvia Angela Yasmine , How Kim Chuan , Susanna Halim

DOI:

10.29303/jppipa.v11i5.10994

Published:

2025-05-25

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Abstract

Drug-induced gingival overgrowth (DIGO) is a condition where the gingiva is abnormally enlarged caused by anticonvulsant, calcium channel blocker, and immunosuppressant drugs. Amlodipine, a calcium channel blocker, is used to treat hypertension and is reported to be the first drug to cause gingival overgrowth. The prevalence of gingival overgrowth induced by calcium channel blockers including amlodipine is 6%-83%. This case report was written with the aim of presenting information on the management of DIGO treatment in hypertensive patients without drug replacement also underlines the importance of integrating science-based health education in dental care to support treatment adherence and patient literacy. The 60-year-old female patient came to the Dental Clinic of Bhayangkara Brimob Hospital with the main complaint of enlarged gums since one year ago almost throughout her mouth. Gum enlargement is slow and painless, but sometimes bleeds when brushing teeth. The patient had a history of high blood pressure and was prescribed amlodipine 10 mg once a day and routinely consumed since the last 5 years. Cleaning of supra and sub-gingival tartar, prescribing chlorhexidine gluconate 0.2% mouthwash to be swished before bedtime, and motivating the patient to continue to maintain oral hygiene. Conclusion: Amlodipine is one of the drugs that cause DIGO (Drug Induced Gingival Overgrowth). Good dental hygiene and patient education have a major role in improving the condition of gingival enlargement.

Keywords:

Amlodipine, Ca channel blockers, DIGO, Gingival overgrowth, Scaling

References

Agnes, C., Anna, F., Bence, K., & Peter, V. (2022). Prevention and non-surgical periodontal therapy of calcium channel blockers induced severe gingival overgrowth. Orvosi Hetilap, 163(13), 506–512. https://doi.org/10.1556/650.2022.32385

Alpi, K. M., & Evans, J. J. (2019). Distinguishing case study as a research method from case reports as a publication type. Journal of the Medical Library Association, 107(1), 1–5. https://doi.org/10.5195/jmla.2019.615

Anuja, N., Dyamavva, H., Preethi A, P., Prasanna, K. R., & Raghavendra, K. (2021). Gingival enlargements: A review. Journal of Dental Problems and Solutions, 8, 029–031. https://doi.org/10.17352/2394-8418.000100

Beaumont, J., Chesterman, J., Kellett, M., & Durey, K. (2017). Gingival overgrowth: Part 1: Aetiology and clinical diagnosis. British Dental Journal, 222(2), 85–91. https://doi.org/10.1038/sj.bdj.2017.71

Brookes, Z. L. S., Bescos, R., Belfield, L. A., Ali, K., & Roberts, A. (2020). Current uses of chlorhexidine for management of oral disease: a narrative review. Journal of Dentistry, 103(January). https://doi.org/10.1016/j.jdent.2020.103497

Crowe, S., Cresswell, K., Robertson, A., Huby, G., Avery, A., & Sheikh, A. (2011). The Case Study Aproach. BMC Medical Research Metohodology, 11. https://doi.org/10.1186/1471-2288-11-100

Deus, F. P., & Ouanounou, A. (2022). Chlorhexidine in Dentistry: Pharmacology, Uses, and Adverse Effects. International Dental Journal, 72(3), 269–277. https://doi.org/10.1016/j.identj.2022.01.005

Devanoorkar, A., & Guttiganur, N. (2019). Interdisciplinary approach in the management of medically compromised patient with drug-induced gingival enlargement. Journal of Interdisciplinary Dentistry, 9(1), 44. https://doi.org/10.4103/jid.jid_68_17

Erken, E. (2016). Amlodipine and gingival hyperplasia; case report with review of the literature. Acta Medica Mediterranea, 32(5), 1605–1608. https://doi.org/10.19193/0393-6384_2016_5_138

Fidan, I., Delamotte, E., Colombier, M.-L., & Agossa, K. (2024). Non-surgical Treatment of Severe Drug-Influenced Gingival Enlargement: A Report of Two Cases. Cureus, 16(6), 1–7. https://doi.org/10.7759/cureus.63214

Gaur, S., & Agnihotri, R. (2018). Is dental plaque the only etiological factor in Amlodipine induced gingival overgrowth? A systematic review of evidence. Journal of Clinical and Experimental Dentistry, 10(6), e610–e619. https://doi.org/10.4317/jced.54715

Ibarra, E. A. D., Pinzón, J. A. A., & Medina, Y. F. (2023). Methodology: How to develop a case report or case series report. Revista Colombiana de Reumatologia, 30(2), 129–136. https://doi.org/10.1016/j.rcreu.2021.05.022

Kamei, H., Furui, M., Matsubara, T., & Inagaki, K. (2022). Gingival enlargement improvement following medication change from amlodipine to benidipine and periodontal therapy. BMJ Case Reports, 15(5), 10–13. https://doi.org/10.1136/bcr-2022-249879

Machirah, Adam, M. A., & Asri, G. D. (2023). Gingivectomy in patients with drug-induced gingival enlargement due to amlodipine consumption. Makassar Dental Jurnal, 12(3), 448–451. https://doi.org/10.35856/mdj.v12i3.888

Maj Raghavendra, M. H., Col Shreehari, A. K., & Srivastava, M. D. (2014). Non-Surgical Management Of A Case Of Amlodipine-Induced Gingival Enlargement. Journal of Evolution of Medical and Dental Sciences, 3(37), 9658–9689. https://doi.org/10.14260/jemds/2014/3252

Michael G., N., Takei, H., R. Klokkevold, P., & Carranza, F. (2018). Newman and Carranza’s Clinical Periodontology (13th ed., Vol. 47, Issue 6). Elsevier.

Misra, S. R., Koduru Lakshmi, S., & Mohanty, N. (2021). Amlodipine induced gingival enlargement. BMJ Case Reports, 14(8), 1–2. https://doi.org/10.1136/bcr-2021-245098

Mojsilović, J., Jovičić, N., Vujović Ristić, S., Stevanović, M., Mijailović, S., Rosić, G., Janković, S., & Kostić, M. (2024). Novel Insights into Amlodipine-Induced Gingival Enlargement: A Clinical and Molecular Perspective. Pharmaceuticals, 17(8). https://doi.org/10.3390/ph17081075

Mona, D., & Prerna, K. (2019). Effectiveness of Non-Surgical Periodontal Therapy on Amlodipine Induced Gingival Enlargement: a Case Report. International Journal of Medical and Biomedical Studies, 3(11), 112–114. https://doi.org/10.32553/ijmbs.v3i11.722

Nath, D., Chauhan, S. S., Sharma, S., & Sinha, A. (2024). Management Of Amlodipine Induced Gingival Overgrowth Via Non-Surgical Approach Introduction. Journal of Research & Methodin Education, 14(3), 1–4. https://doi.org/10.9790/7388-1403010104

Portnoy, P. S., Lee, S. Y., McMullen, A., & Qu, V. (2022). Amlodipine-Induced Gingival Overgrowth: A Health Justice Issue. Journal for Nurse Practitioners, 18(1), 123–127. https://doi.org/10.1016/j.nurpra.2021.10.014

Quenel, L., Keribin, P., Giran, G., Tessier, M.-H., & Lesclous, P. (2020). Amlodipine-induced gingival enlargement: a case report. Journal Stomatol Oral Maxillofacial Surgery, 121, 308–311. https://doi.org/10.1016/j.jormas.2019.04.014

Raghu, N., Deepak, P., Suresh, R. M., & Manjula, M. J. (2021). Amlodipine-induced gingival hyperplasia. 11(07), 803–805. https://doi.org/10.5455/njppp.2021.11.01025202103022021

Sabarudin, M. A., Taib, H., & Wan Mohamad, W. M. (2022). Refining the Mechanism of Drug-Influenced Gingival Enlargement and Its Management. Cureus, 14(5). https://doi.org/10.7759/cureus.25009

Sailendranath, Saha, A., Kumar, A., Nair, V., & Debabrata. (2017). Anti- Hypertensive Drug Induced Gingival Enlargement-A Case REPORT. Journal of Disease and Global Health, 10(1), 7–11. Retrieved from https://ikprress.org/index.php/JODAGH/article/view/2351

Samudrala, P., Chava, V. K., Chandana, T. S., & Suresh, R. (2016). Drug-induced gingival overgrowth: A critical insight into case reports from over two decades. Journal Indian Soc Periodontal, 5, 496–502. https://doi.org/10.4103/jisp.jisp_265_15

Sharma, N. K., & Roopa, D. A. (2014). Nonsurgical Management of Amlodipine Induced Gingival Enlargement – A Case Report. International Journal of Dental Sciences and Research, 2(6), 137–140. https://doi.org/10.12691/ijdsr-2-6-4

Shome, S., De, A., Ghosh, A., & Saraf, A. (2021). Amlodipine induced generalized gingival overgrowth: A clinical case. IP Archives of Cytology and Histopathology Research, 6(2), 125–127. https://doi.org/10.18231/j.achr.2021.030

Singh, A., Singh, R., & Manjunath, R. G. S. (2023). Non Surgical Treatment of Amlodipine Induced Gingival Overgrowth. International Journal of Health Sciences and Research, 13(6), 108–111. https://doi.org/10.52403/ijhsr.20230618

Stojanovska, A. A., & Isa, M. (2024). Management of amlodipine-induced gingival enlargement-case report. International Dental Journal, 74, S280. https://doi.org/10.1016/j.identj.2024.07.228

Triveni, M., Rudrakshi, C., & Mehta, D. (2009). Amlodipine-induced gingival overgrowth. Journal of Indian Society of Periodontology, 13(3), 160. https://doi.org/10.4103/0972-124X.60231

Tungare, S., & Paranjpe, A. (2025). Drug-Induced Gingival Overgrowth. StatPearls Publishing LLC.

Author Biographies

Rike Rayanti, Bhayangkara Brimob Hospital and World Stomatology Institute

Sylvia Angela Yasmine, Internship of Dentist at Bhayangkara Brimob Hospital

How Kim Chuan, Faculty of Medicine University Tunku Abdul Rahman and World Stomatology Institute

Susanna Halim, University of Prima Indonesia

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How to Cite

Rayanti, R., Yasmine, S. A., Chuan, H. K., & Halim, S. (2025). Case Report of Drug-Induced Gingival Overgrowth (DIGO) in Amlodipine User at Bhayangkara Brimob Hospital. Jurnal Penelitian Pendidikan IPA, 11(5), 1046–1054. https://doi.org/10.29303/jppipa.v11i5.10994