Amlodipine-Induced Gingival Hyperplasia Does NOT Regenerate Receding Gums
No, amlodipine-induced gingival hyperplasia does not help grow back receding gums—it causes pathological overgrowth of gingival tissue that is entirely distinct from physiologic gum regeneration and must be treated as an adverse drug effect, not a therapeutic benefit. 1, 2, 3
Understanding the Pathology vs. Regeneration
What Amlodipine Actually Causes
Amlodipine causes fibroepithelial overgrowth with connective tissue hyperplasia, not true gingival regeneration—histological analysis reveals hyperplastic connective tissue, epithelial acanthosis, and elongated rete ridges with inflammatory cells, which represents pathological tissue proliferation. 4
The overgrowth typically manifests as lobular or nodular enlargement on interdental papilla, predominantly in anterior interproximal regions, occurring in approximately 3.4% of patients taking amlodipine. 5
This drug-induced hyperplasia is exacerbated by poor plaque control and gingival inflammation, making it a disease process rather than a regenerative one. 3, 5
Why This Cannot Treat Gingival Recession
Gingival recession requires regeneration of lost periodontal attachment, cementum, and bone—not simply tissue bulk—and amlodipine-induced hyperplasia produces disorganized fibrous tissue without restoring the periodontal ligament or proper tissue architecture. 6
Long-term gingival margin stability requires at least 1.46mm of keratinized tissue thickness and proper tissue quality, not pathological overgrowth that lacks functional attachment and is prone to inflammation. 6
Clinical Management Algorithm
When Amlodipine-Induced Hyperplasia is Diagnosed
Immediately implement meticulous oral hygiene with professional scaling and root planing as first-line intervention to reduce inflammatory component. 1, 2
Coordinate with the prescribing physician to substitute amlodipine with an alternative antihypertensive (ACE inhibitors, ARBs, or thiazide diuretics) that does not cause gingival hyperplasia. 6, 7
Perform surgical excision of hyperplastic tissue only after drug substitution and optimization of oral hygiene, as the tissue will recur if the causative drug continues. 1, 2
Critical Distinction from Ciclosporin
Calcium channel blockers like amlodipine can be switched to tacrolimus in transplant patients to avoid gingival hyperplasia, as tacrolimus does not cause this side effect, whereas ciclosporin combined with calcium channel blockers creates additive risk. 6
The British Association of Dermatologists specifically notes that calcium antagonists used to treat ciclosporin-induced hypertension have the disadvantage of inducing gingival hyperplasia, possibly adding to ciclosporin's effect. 6
Proper Treatment for Gingival Recession
Evidence-Based Regenerative Approaches
Autogenous connective tissue grafts remain the gold standard for treating gingival recession, achieving very high rates of mean and complete root coverage for type 1 recession defects with predictable phenotype modification. 6
Growth factors like rhPDGF-BB with appropriate scaffolds can promote true periodontal regeneration, including new cementum, periodontal ligament with Sharpey fibers, and bone—outcomes that drug-induced hyperplasia cannot achieve. 6
Free gingival grafts predictably produce at least 1.5mm of keratinized tissue width, the minimum threshold for long-term gingival margin stability, through proper surgical technique rather than pathological drug effects. 8
Common Pitfalls to Avoid
Never continue amlodipine hoping the hyperplasia will "fill in" receded areas—the pathological tissue lacks proper attachment and will worsen oral hygiene, potentially accelerating periodontal disease. 3, 5
Do not perform surgical excision without first addressing the causative drug, as recurrence is inevitable if amlodipine continues, wasting surgical resources and patient recovery time. 1, 2
Recognize that gingival hyperplasia can develop rapidly (within 2 months in documented cases) and requires prompt intervention rather than observation. 4