The numbers of patients using medications that induce gingival overgrowth are expanding rapidly. The tremendous increase in the number of organ transplants being performed, each requiring treatment with the immunosuppressive drug of choice, cyclosporine, has created a new dilemma in management of the gingival tissues. Additionally, cyclosporine-induced hypertension is frequently treated with calcium channel blockers, such as nifedipine, both drugs acting synergistically to induce gingival overgrowth. At present, the profession lacks a well-defined and easy-to-use clinical index for classifying overgrown gingival tissue. This article describes a comprehensive, yet simple, scoring system for enlarged tissues that may provide direction to the clinician and standardize evaluation. This system may also give guidance for the most appropriate time for surgical treatment of drug-induced gingival overgrowth.