Calcium Antagonists and Deep Gingival Pockets

Objectives: Gingival overgrowth is a common undesired side effect in patients taking calcium antagonists. Different reports have suggested that the drug-induced gingival hyperplasia may aggravate inflammatory periodontal disease. However, representative and relevant epidemiological data are lacking. We investigated the association between the intake of calcium channel blockers and periodontitis in a population-based analysis. Methods: We conducted a cross-sectional epidemiological investigation involving 4,290 subjects aged 20 – 80. We recorded periodontal risk factors in interviews and questionnaires and identified participants using calcium antagonistic drugs. Periodontal parameters, viz. attachment loss, probing depth and number of teeth were assessed. In a subgroup analysis with matched pairs, 456 subjects using calcium antagonists and 456 without were compared for periodontal status. Results: Subjects treated with calcium antagonistic drugs had significantly deeper gingival pockets than their drug-free counterparts. This was observed in the total population of 4,290 and confirmed by logistic regression analyses (p < 0.001) controlled for the known risk factors of periodontitis (age, sex, smoking, education). In the matched-pair analysis only the probing depth was increased (p < 0.001); no differences were found in extent and severity of clinical attachment loss. There was no difference in the number of teeth. The risk of gingival overgrowth was aggravated in smokers. Conclusions: In the general population, treatment with calcium antagonists leads to gingival overgrowth without an aggravation of periodontal disease. Interaction with smoking indicates the multifactorial background of the undesired effect of calcium antagonists.