Non-inflammatory mechanisms include the following: (1) a decrease in sodium flux by the drug, leading to reduced cellular folate uptake and subsequent collagenase deficiency, resulting in impaired connective tissue catabolism and the clinical presentation of drug-induced gingival enlargement; (2) an increase in adrenocorticotropic hormone levels due to the blocking of synthesis in the adrenal cortex; and (3) the upregulation of transforming growth factor-beta 1 (TGF- β1) due to inflammation in the gingival cervical fluid. This evidence concerns the gene TGFB1 and gingival overgrowth.