A Rare Case of Sodium Valproate Induced Gingival Overgrowth in an Adult Patient
Authors: Nisha V. Patel and Vijay L. Deshmukh
Abstract: Purpose: Drug induced gingival overgrowth is frequently observed with the use of several types of therapeutic agents like anticonvulsants, immunosuppressants and calcium channel blockers. Among antiepileptic drugs, phenytoin has been frequently linked with gingival overgrowth but there are very few reported cases of sodium valproate induced gingival overgrowth. This case report describes gingival overgrowth in an adult patient due to chronic use of sodium valproate complicated due to poor oral hygiene and its periodontal treatment. Methods: A 24 year old female patient reported with marked gingival overgrowth since five and a half years. Patient was taking sodium valproate for treatment of complex partial seizures since the age of 18. She noticed gingival overgrowth 5 months after starting the medication. The case was diagnosed as sodium valproate induced gingival overgrowth based on medical history, clinical and histopathologic examinations. The offending drug was substituted with carbamazepine by patientís physician and initial periodontal therapy was given. Periodontal flap surgery was carried out to surgically excise the enlarged tissue and treat the periodontal involvement. Results: Periodontal treatment resulted in satisfactory clinical outcome with good gingival contour, reduction in probing depth and gain in clinical attachment. The results were well maintained at the end of six months. Clinical Significance: The present case shows marked gingival overgrowth associated with chronic use of sodium valproate in an adult patient. Clinicians should be aware of such possible effects to detect early changes in gingival tissues of patients under this medication which will help in preventing further complications.