Medications & Your Oral Health

How Medications Affect Your Oral Health

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Many people are taking medications now that help stabilize or improve our health.  Although medications help with increased quality of life and disease management; they can also have a variety of affects on our teeth and oral health. Knowing how medications affect your oral health can help combat the side effects from causing harm. Understanding the common side effects, types of medications to be aware of, and how to combat the effects can help improve your overall oral health and teeth as we age.

Some of the common side effects of medications are dry mouth (xerostomia), tooth decay, acid erosion, gum tissue issues, teeth staining, bone density and grinding teeth (bruxism).

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Dry mouth; also known as xerostomia can sometimes have a significant impact on your teeth and gum health. Saliva helps protect teeth by neutralizing the pH and washing away food and bacteria biofilm. When the saliva volume is low in the mouth there can be an increased risk of tooth decay and gum disease. Dry mouth symptoms can be mild to severe, and can lead to oral discomfort. The discomfort can compromise dietary intake and quality of life. With over a thousand medications associated with dry mouth or decrease in saliva; many people worldwide are affected by this condition. Common medications to cause dry mouth include: Antihistamines, Antidepressants, Diuretics and Beta-Blockers, Decongestants, Opioids, Antihypertensive, Sedatives, and muscle relaxants to name a few. With many patients taking multiple medications the side effects of dry mouth can be even greater.^1,2

Besides medications contributing to dry mouth there are certain medications that can also affect your gum tissue that can cause your gums to overgrow (gingival hyperplasia). Others can cause the gum tissue to be inflamed or bleed more. Common classification of medications that can cause gingival enlargement are Anticonvulsants, Calcium channel blockers, and immunosuppressants.³

Besides the side effects of dry mouth on the increase in cavities and gum issues; medication can affect staining of the teeth; such as tetracycline antibiotics can cause staining in children in development. Some medications also contribute to acid erosion that erodes the enamel from the teeth. For example, studies have shown that aspirin, if chewed, can lead to tooth erosion.⁴

Medication can also affect the bone and jaw muscles. For example, antidepressants or antipsychotics, can cause side effects like bruxism, which can wear down teeth and lead to jaw pain or tooth fractures. There are also medications that cause bone density issues such as bisphosphonates for osteoporosis which can also affect the jaw bone. This can lead to tooth loss or difficulty with dental implants.

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How to Combat the Effects of Medications

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There are things you can do to combat the side effects.  To help improve your oral health when taking medication you can use fluoride toothpaste, increase in at home oral hygiene, and regular oral health dental check ups to help manage any potential side effects on your mouth. Application of 5% fluoride varnish at dental appointments and use of other preventions can help with cavity prevention. Salivary stimulants can also be beneficial with dry mouth to help with your overall oral health comfort and prevention. Always talking to your medical provider and dental provider with your questions or concerns.²

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References

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1. Roseann Mulligan, DDS, MS, Piedad Suarez-Durall, DDS and Phuu Han, BDS, DDS, PhD.  “Dry Mouth: Medications and their Effect on Saliva” Geriatric Dentistry 2019 October 19
2. “Xerostomia” Research Services and Scientific Information, ADA Library & Archives. April 2023
3. Renita Castelino, Sajad Buch, Anusha Rangare. “Nifedipine-induces Gingival Enlargement: A care report review”  Current Medical Journal. January 2021 Pg 54-57
4. “Does Aspirin Cause Tooth Erosion” Accessed in November 2024

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