Drug-induced gingival enlargement (DICE) is a biofilm-mediated gingival inflammatory condition associated with pharmacological agents. Specifically, calcium channel blockers, immunosuppressants, and anticonvulsants are among the primary medications associated with DICE. Modifiable risk factors for DIGE include drug dose mild dental biofilm, and the use of concomitant inducing medications. Although the clinical presentation of DICE depends on these and patient-specific variables, its classical appearance is described as fibrotic, pink, bulbous, or mulberry-shaped overgrowths of the attached gingiva and dental papillae, with no bleeding on probing. The clinical manifestations of DICE, may worsen as the disease increases in severity. Likewise, the treatment strategies become more complex. The dental management of DIGE includes nonsurgical, surgical if necessary, and maintenance therapies. Drug substitutions, which may only be considered in consultation with the patient's family physician or primary healthcare provider, are a form of nonsurgical therapy. DICE can be extremely debilitating, especially in its advanced stages, and make oral hygiene cumbersome, which translates to poorer oral and periodontal health outcomes. Therefore. DIGE must be properly identified and treated accordingly to re-establish a healthy and maintainable periodontium.