What is the appropriate initial treatment for a patient with significant gingival hyperplasia due to Dilantin use?

The appropriate initial treatment for a patient with significant gingival hyperplasia due to Dilantin use is to provide oral hygiene instruction, perform prophylaxis, scaling, and then consider gingivectomy as necessary.

In cases of gingival hyperplasia, especially when it's drug-induced like in the case of Dilantin (phenytoin), the first step is usually to improve the patient's oral hygiene. This includes educating the patient on effective brushing and flossing techniques to reduce plaque accumulation, which can exacerbate the gingival condition.

Following this, a dental prophylaxis (cleaning) and scaling are performed to remove tartar and plaque from the teeth and gingiva, which can help in managing the inflammation and may alleviate some of the hyperplasia symptoms. Lastly, a gingivectomy may be necessary if the hyperplasia does not improve significantly with these initial interventions. This approach is a more conservative and effective method rather than opting for more invasive surgical procedures right away.

The other options, such as performing gingivectomy first or immediate extraction of affected teeth, may not address the underlying cause of the hyperplasia or may be more aggressive than what is initially necessary. Meticulous oral hygiene and scaling often lead to improved gingival health, making surgical procedures