Hiperplasia gengival associada ao uso da fenitoína

Abstract

Gingival hyperplasia can be caused by some medicines, including phenytoin, and its prevalence is approximately 50%. The aim of this study was to evaluate the prevalence of gingival hyperplasia between users of phenytoin of the Visconde do Rio Branco Health Center and instruct health professionals about the side effects of this drug for oral health. This was a cross-sectional study, where patients in use of phenytoin enrolled in Visconde do Rio Branco Health Center were evaluated, in 2009, in relation to the presence of gingival hyperplasia. All 52 patients from the electronic list of the pharmacy of the Health Center that make use of phenytoin were invited to participate in this study. For the patient´s periodontal condition evaluation, a calibration of an examiner was conducted using photographs. From the records of the Basic Health Unit pharmacy (UBS), patients in use phenytoin were invited by a letter delivered by the community health agents (ACS), to attend to the UBS, where they were evaluated by the calibrated examiner in the pilot study, using artificial lighting, clinic mirror an periodontal probe. Parallel to the evaluation of the patients, professionals of the Health Center and NASF (Support Center of Family Health) were invited to attend a lecture about gingival hyperplasia. After the lecture the participants were requested to complete a questionnaire. Of the 52 patients using phenytoin only 10 (19.2%), attended. Of those, 4 had gingival hyperplasia (40%) and 6 had healthy gum. About the knowledge of gingival hyperplasia associated with phenytoin, 79.2% of the professionals did not know the gingival hyperplasia; 89.6% never sent to a dentist any case of gingival hyperplasia and 93.7% reported that they did not know the causes of gingival hyperplasia. Two intervention proposals were made: direct approach with the users of phenytoin and consciousness of health professionals about the gingival hyperplasia associated with phenytoin, which was done through lectures. The proposal of a direct approach with phenytoin users proved not to be effective, since only 10 (19.2%) of 52 users of phenytoin, attended. The professional approach proved to be more appropriate to the solution of the problem, because when asked if the presentation about the theme contributed to his professional life, 100% answered yes. It was concluded that an important factor in the control of gingival hyperplasia is the participation of the entire family health team, aiming the patient consciousness.