By DR. AMANDA RIZNER
Everyday medications play a crucial role in maintaining our overall health and managing various medical conditions. While they can provide numerous systemic benefits, it’s important to recognize that many medications can also have unintended side effects, some of which can impact oral health, including teeth and gums. In this article, we will explore how medications can affect your teeth and gums.
Dry mouth
One of the most common side effects of medications is dry mouth, also known as xerostomia. When the mouth cannot produce enough saliva, it cannot neutralize acid correctly. This can lead to tooth decay, erosion, plaque retention, and an overgrowth of oral bacteria. Some patients will notice this symptom rapidly with the onset of a new medication, whereas others it may take a few months to notice any effect on the oral cavity. Patients who suffer from this condition often present with tooth root cavities around the gumline, and they can be found in patients with overall good homecare simply due to the lack of salivary flow. We often recommend products such as lozenges, mouth rinses, and prescription toothpastes targeted at treating xerostomia. If patients present with a high decay risk, we may also recommend shorter recall intervals for cleanings in order to catch decay at the gumline when it first starts and is treatable easier. Dry mouth caries tend to progress quickly due to their location on the teeth, which can sometimes make treatment more difficult and costly.
Common medications known to cause to dry mouth include: antidepressants, antihistamines, antipsychotic medications, and cancer/radiation treatments and drugs.
Gingival Overgrowth
Some medications, specifically heart medications, can cause the gingival tissue to grow over the teeth with time. This can make cleaning the plaque very difficult and can be a cosmetic concern for patients. Calcium channel blockers and anticonvulsant medications seem to be the most common culprits of gingival hyperplasia. Keeping the oral cavity as clean as possible using tools such as a water flosser and electric toothbrush are essential for preventing the overgrowth of tissue and preventing periodontal disease. Treatment for gingival overgrowth can range from changing the type of drug the patient’s on to lasering the tissue in order to provide better cleansability.
Osteoporosis Drug Induced Jaw Necrosis
Many people are placed on drugs to treat osteoporosis, but little are aware of the side effects some of these drugs can have on the bone in the oral cavity. Taking certain drugs, called bisphosphonates, can potentially lead to a condition called osteonecrosis of the jaw. It’s important to note that only a small subset of patients will experience this and it is dependent on the patient, their systemic health, and presence of infection of the oral cavity. We urge patients who are considering taking these medications to have a consult with their dentist before starting, in order to make sure all major infections are taken care of. Some surgeons will also recommend a drug holiday for some of these medications before major dental work is done. It is best to disclose to your dentist if you’ve ever taken or are considering taking these types of drugs before dental work is started.
Bleeding
Many patients are placed on blood thinning/antiplatelet medications for numerous reasons these days. This can lead to generalized gingival bleeding throughout the oral cavity. Most patients on these types of medications can easily control their gingival bleeding by good home care and frequent cleanings. If more extensive dental work is needed, we may request a medical clearance from your cardiologist to stop these types of drugs for a few days, in order to control the bleeding for your procedure. If a patient is experiencing heavy bleeding while brushing daily, it is important to visit your dentist to find out the cause and make sure no infection is present.
In conclusion, medications can have various effects on your teeth and gingiva. It is crucial for patients to be aware of these potential side effects and work collaboratively with their healthcare providers and dentists to maintain optimal oral health, while managing their medical conditions. With proper communication and proactive oral care, many of the negative effects of medications on oral health can be mitigated or prevented. This allows patients to enjoy the benefits of their prescribed treatments without compromising their dental well-being.
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