Phenytoin is associated with gingival hyperplasia. What nursing instruction is appropriate regarding dental care for a patient taking phenytoin?

• A. Phenytoin does not affect gums; dental hygiene is not a concern
• B. Phenytoin can cause gingival hyperplasia; emphasize dental hygiene and regular dental visits
• C. Phenytoin should be discontinued before dental procedures
• D. Gingival tissue improves with phenytoin and requires no care

Answer: (B)

Phenytoin can cause gingival hyperplasia, so the nursing approach should focus on preventing and managing gum overgrowth through diligent dental care. Emphasize meticulous oral hygiene: brush with a soft-bristled brush after meals, use fluoride toothpaste, and clean along the gum line; floss daily; and, if advised, use an antiseptic mouthwash. Reinforce the importance of regular dental visits for professional cleanings and monitoring, since plaque and inflammation can worsen gingival overgrowth. If gingival changes occur or worsen, coordinate with the prescriber about management options—discontinuing the medication isn’t a nursing action, and any change would be guided by the clinician.