The effect of isotretinoin therapy on the gingiva: Prospective case control study

Abstract

Introduction: Acne is one of the common condition affecting the skin and represents the first reason for consultation in private dermatology practice. Isotretinoin is an efficient drug utilized for the management of acne, and is thought to cause dry mouth following prolonged use. Gingivitis is a term used to describe non-destructive periodontal disease that results in inflammation of gingiva. Early diagnosis of gingivitis associated with isotretinoin is important and further progression can be prevented by altering its dose.

Material and methods: This prospective case control study was conducted in the Dental clinics, College of Dentistry, Al Qassim University. The participants of the study were chosen as simple random samples from the patients on Isotretinoin therapy who visited Dermatology Department, Medical city, Qassim University and the patients who visited the dental clinics. All those who agreed to participate in the study were explained about the purpose of the study and informed consent was taken.

Results: The study aimed to assess the effects of isotretinoin therapy on the gingiva and the oral mucosa. Six index teeth were included to assess gingival status and plaque levels. The study included 61 subjects, of which 32 were on isotretinoin therapy, and 29 were kept as controls (un-treated).

The analysis showed that the gingival scores for teeth 16, 36, 12, 32, 24, and 44 in the isotretinoin group were 1.75± 0.6, 2.03 ±0.7, 2.06± 0.7, 2.00±0.7, 2.06±0.7, 2.00±0.7, 1.98±0.6 respectively, which were significantly higher compared to the gingival scores of all the index teeth from the control group (p<0.001) .  Similarly, the mean scores for plaque index were significantly higher in isotretinoin treated subjects when compared with the controls (p<0.001).

Conclusion: The gingival inflammation was significantly more in patients on isotretinoin than those who didn't use it despite the drug's anti-inflammatory effect. The dental plaque levels were also significantly higher in subjects who used isotretinoin. Thus, it cannot be concluded that gingival inflammation was due to isotretinoin or the increased plaque levels.