Which of the following drugs could have caused enlarged gingiva?

Enlarged gingiva, or gingival hyperplasia, can be caused by several medications, with phenytoin being one of the most well-known contributors. Phenytoin, an anticonvulsant primarily used to prevent seizures, has a side effect profile that includes the potential for causing gum overgrowth. This occurs because phenytoin influences cell proliferation and survival in gingival tissue, leading to excess growth.

In patients taking phenytoin for prolonged periods, regular dental care and oral hygiene become essential since the enlarged gingival tissue can create challenges for maintaining proper oral health and may lead to increased plaque accumulation, which in turn can exacerbate other oral health issues.

While other drugs listed may have varying oral side effects, they are not typically associated with gingival enlargement in the same manner as phenytoin. For instance, marijuana may cause dry mouth and alterations in saliva production, while Xanax and Wellbutrin have different side effects that do not include changes to the gingival tissues.