Drug-induced gingival enlargement is most commonly observed affecting which gingival region first?

Drug-induced gingival enlargement typically begins in the interdental papillae, particularly in the anterior facial region, before extending to involve the free gingival margin and, in severe cases, the attached gingiva. The anterior teeth are most commonly affected, which has significant esthetic implications. Posterior regions may also be involved in severe cases. The enlargement presents as firm, pink, nodular or lobulated fibrous tissue when inflammation is absent, but becomes red and hemorrhagic when compounded by plaque-induced inflammation.