Gingival enlargement, a side effect of amlodipine, presents

challenges in the management of periodontal disease. This

study addresses the synergy between non-surgical periodontal

treatment and medication modification in hypertensive

patients using amlodipine, while also demonstrating the

impact of medication changes, patient follow-up, and

oral hygiene education on periodontal treatment efficacy.

A 51-year-old female patient presented to our clinic with

complaints of gingival enlargement and bleeding. Upon

taking her medical history, it was found that she had

been using an amlodipine derivative (Norvasc) as an

antihypertensive medication for six years and that her

gingival complaints began four years ago. Comprehensive

evaluations and clinical periodontal measurements led

to a customized non-surgical periodontal treatment

regimen (supragingival plaque control, scaling, root

surface debridement, and adjunctive antibiotics). Initially,

treatment was carried out while the patient continued using

amlodipine, followed by routine weekly check-ups for 12

months. This phase of treatment showed limited success

and required reevaluation. Althought bleeding on probing

had stopped, gingival enlargments were still persistent.

After consultation with her cardiologist, the medication

was changed to optimize systemic and periodontal health

(switching from Norvasc to Diltiazem). Subsequently,

non-surgical periodontal treatment and careful patient

monitoring were repeated. The results showed a significant

reduction in gingival enlargement, absence of bleeding on

probing, and increased aesthetic satisfaction. This case

highlights the complex relationship between systemic

medications and periodontal health.