Increasingly popular heart and blood pressure drugs are causing gum swelling that can
turn into serious gum disease if untreated.
About 25% of the millions of people taking calcium channel blockers -- drugs used to
control high blood pressure and treat angina -- experience gum enlargement, says Sebastian
Ciancio, a periodontist and professor at the University at Buffalo School of Dental
Medicine. Swollen gums make it easier for bacteria to accumulate on the teeth, invade gum
tissue and spread to a tooth's bony support. If too much bone is lost, teeth can fall out.
Procardia and Cardizem, the two most popular calcium channel blockers, are taken by
about 3 million patients. Dilantin, used to control epileptic seizures, and cyclosporins,
which prevent rejection of organ transplants, also can cause gum swelling.
Enlarged gums also make it harder for patients to properly brush or floss away
bacterial plaque from teeth. That can increase infection.
Sally Cram, a Washington, D.C., periodontist, says that if the swelling is caught early
enough, it is easily treatable. She will clean patients' teeth thoroughly and put patients
on a rigorous dental hygiene program -- and recommend that their doctors consider
switching them to another medication. Still, surgical removal of the excess tissue may be
needed in severe cases, she says.
Ciancio says patients are not adequately warned about the risks. Pfizer, which sells
Procardia, and Hoechst Marion Roussel, which sells Cardizem, list gum swelling among the
drugs' side effects. Leaflets distributed by pharmacists recommend that patients using
Procardia XL brush and floss their teeth to reduce swelling and tenderness and consult
doctors if they have gum problems. Cardizem users also are advised to consult physicians
if they experience gum swelling.
Pfizer spokesman Brian McGlynn says less than than half of 1 percent of participants in
clinical trials for Procardia experienced gum swelling. ``And we have our ears up very
sharply for this sort of thing,'' McGlynn says.
``We haven't seen it as a great problem,'' says Hoechst spokesman Charles Rouse. ``But
that doesn't mean it's not of concern.''
Ciancio says dentists and periodontists are not adequately reporting the growing number
of cases of gum enlargement. But he also worries that heart doctors aren't taking the side
effects seriously. ``Whenever we tell a physician that the drugs are causing gum
enlargement, they say, `You're a dentist -- what do you know about drugs?' '' Ciancio
He says patients should be vigilant about oral hygiene while they are on Procardia,
Cardizem or any of the other drugs known to cause gum enlargement.
Patients who notice a change in their gums while taking a medication should see their
dentist to get a diagnosis and to see whether they should change medications, Ciancio