Dilantin-Gum Overgrowth

  : : Although I have posted before and hate to take up your time, I would
  : : like to ask some questions about dilantin and gum overgrowth.  I know that gum
  : : problems are a side affct of dilantin but how can I fight this problem?
  : : I have only had grand-mal seizures within days of giving birth of my last two
  : : children and have had no seizures at any other times unless they have been
  : : of a very mild type and I have had some strange experiences so I'm not sure
  : : if they were seizures or not.  I have an appointment with my doctor on the 30TH
  : : and since I have no neurologist would greatly value your opion.  I am just lately
  : : starting to experience gum changes, such as swelling, redness, bleeding, but
  : : since I have a nephew with this problem and know the outcome, I am very upset.
  : : I would like to know how long does a person need tobe seizure befor it
  : : is safe to go off the medication?  I take a dosage of 500mg per day and
  : : would like to start tapering it off and eventually get off completely.
  : : My last round of seizures were on 3/20/98.  Any advice would be helpful.
  : Dear Crager:
  : Sorry to hear about your gum problems.  Approximately 50% of people on dilantin get gum disease.  We are unsure why, but it happens.  Extremely good gum care is needed to prevent gum overgrowth.  We have found with good dental care, 6 month visits to the dentist is a must, and proper dental care (flossing, brushing etc) the effects of dilantin on gum disease can be minimized.  We are beginning a clinical study to see if a medication might be useful in preventing and once present reducing gum overgrowth.  When the study is completed, the results will be published and if it works (Since I am running the study I feel like it will work) then your doctor can put you on the medication.
  : As far as when one can stop medication for epilepsy is complex and different epileptologist handle it different.  Alot of it would have to depend on your EEG, MRI, family history.  If the MRI were completely normal, the EEG normal, and a negative family history, then 2 years of being seizure free on medication would be the majority view.  However, if the modalities of MRI or EEG or family history are not normal, then it becomes a more difficult question.  That would depend on what and how abnormal the tests were.  Without knowing what your tests showed, I really can not make a speculation.  At least, most of the time your seizures are under control.  Given the fact that you still have break through events, I would doubt if your physician would take you off medication at the moment.  Best of luck.
  : Sincerely,
  :
  : CCF Neuro[P] MD
  I know this wasn't my post but it does kind-of relate to my question.
  How long is it before gum over growth starts in people after taking Dilantin? Is it related to the dosage? I've been on Dilantin for about a month and I do have tender gums that can get swollen and bleed but no over growth...is that likely to be the next step? Dilantin has controled my seizures 100% so far since I've started taking it and it would be a shame to have to change medications due to this sideffect. Thank-you! -Wren
Dear Wren:
I am glad that your seizures are under control.  As stated in the previous posting, Dilantin-induced gingival hyperplasia occurs in anywhere from 50% to 70% of all patients on dilantin therapy.  It can occur at any time.  You need to really take care of your teeth.  Frequent cleanings by the dental office, flossing and brushing.  It is a tough battle, but it can be won.  As soon as the final results from our study come out, I hope that the data will be encouraging and we can use medical management together with dental hygiene, instead of gum surgery.  Stay tuned but in the mean time, good and strict dental hygiene is needed.  Best of luck.
Sincerely,
CCF Neuro[P] MD