When discharging a child on phenytoin therapy for epilepsy, which teaching point is most important to prevent a common adverse effect?

• A. Drink plenty of fluids
• B. Brush teeth after meals
• C. Have someone stay with the child during waking hours
• D. Report signs of infection

Answer: (B)

Phenytoin commonly causes gingival hyperplasia. The most important teaching is to maintain excellent oral hygiene, especially brushing after meals, to remove plaque and reduce gum inflammation that leads to gum overgrowth. Regular flossing and dental visits reinforce this protective effect. Drinking fluids is healthy but does not specifically prevent this gum overgrowth. Safety during seizures and reporting infection signs are important for other reasons, but they don’t address the most common medication-related adverse effect.