Summary
Summary ( 14 Questions)
A patient who has been taking phenytoin for several years comes to the clinic for a follow-up visit and tells the nurse that he has been experiencing gum tenderness and bleeding when he brushes his teeth. The nurse will perform which action?
Choice A is wrong because flossing his teeth regularly may not prevent or reduce the gingival overgrowth caused by phenytoin. Flossing may also aggravate the bleeding of the gums.
Choice B is wrong because serum drug levels may not correlate with the extent of gingival overgrowth. Some studies do not support the concept that the dose, duration, and plasma levels of phenytoin affect the severity of gingival enlargement².
Choice C is wrong because this is not a harmless side effect of phenytoin. Gingival overgrowth may interfere with speech, mastication, tooth eruption and aesthetics². It may also increase the risk of periodontal disease and infection³.
This is because phenytoin, a medication used to control seizures, may cause gingival hyperplasia or overgrowth of the gums¹. This can lead to tenderness, swelling, or bleeding of the gums. The condition is more common in patients taking phenytoin, cyclosporine, or calcium channel blockers¹. The etiology of phenytoin-induced gingival enlargement is likely due to the direct effects of the drug and its metabolites on the gingival fibroblasts¹. Patients can benefit from controlling the inflammatory component through an appropriate oral hygiene program¹. Referral to a general dentist or periodontist is appropriate for management¹.
This is because phenytoin, a medication used to control seizures, may cause gingival hyperplasia or overgrowth of the gums¹. This can lead to tenderness, swelling, or bleeding of the gums. The condition is more common in patients taking phenytoin, cyclosporine, or calcium channel blockers¹. The etiology of phenytoin-induced gingival enlargement is likely due to the direct effects of the drug and its metabolites on the gingival fibroblasts¹. Patients can benefit from controlling the inflammatory component through an appropriate oral hygiene program¹. Referral to a general dentist or periodontist is appropriate for management¹.
Choice A is wrong because flossing his teeth regularly may not prevent or reduce the gingival overgrowth caused by phenytoin. Flossing may also aggravate the bleeding of the gums.
Choice B is wrong because serum drug levels may not correlate with the extent of gingival overgrowth. Some studies do not support the concept that the dose, duration, and plasma levels of phenytoin affect the severity of gingival enlargement².
Choice C is wrong because this is not a harmless side effect of phenytoin. Gingival overgrowth may interfere with speech, mastication, tooth eruption and aesthetics². It may also increase the risk of periodontal disease and infection³.