Gingival hyperplasia is a common side effect of which anticonvulsant?

• A. Carbamazepine
• B. Valproic acid
• C. Lamotrigine
• D. Phenytoin

Answer: (D)

Gingival hyperplasia is a classic adverse effect of phenytoin, an older anticonvulsant. Phenytoin promotes gingival fibroblast growth and alters the balance of collagen production and breakdown in the gum tissue, causing the gums to enlarge. Inflammation from plaque can worsen this overgrowth, and the risk tends to rise with longer use and higher doses. Clinically, patients may notice swollen, bulky gums that can bleed and trap food, making brushing and eating uncomfortable.

Management centers on maintaining excellent dental hygiene and regular dental visits; in some cases, if the overgrowth is significant or troublesome, switching to a different anticonvulsant may be considered under medical supervision. The other anticonvulsants listed are not commonly linked to gingival overgrowth, though they have their own distinct side-effect profiles.