While bisphosphonate-induced osteonecrosis of the jaw is the most commonly-referenced oral health side-effect of a medication, there are a number of other medications that can pose a danger, often through the side-effect of xerostomia. Dry mouth is perhaps one of the most overlooked complaints, and many patients may not even know they have it, instead reaching for another fizzy beverage or sucking on yet another piece of candy to relieve the "itch."
The list of medications with the side-effect of xerostomia is quite large, so here are some common categories to look out for.
Seeing these on a patient medication list should automatically mean careful observation for gastroesophageal reflux erosion, but these medications can also harm teeth on their own. Some are sweetened with sugar or cariogenic artificial sweeteners, and since many people only notice heartburn after going to bed, the sugar will be in contact with the tooth surface until the next morning.
Many pain medications, including opioids, are known for their unpleasant side-effects, which often include nausea, constipation, and xerostomia. Whether taken recreationally or for severe pain, either life situation often means that hygiene and diet are neglected in combination with the xerostomia, which can hasten decay rapidly.
Blood pressure medication
Angiotensin-converting enzyme inhibitors, beta blockers, diuretics and more are used in combination with others to treat one of the most common health complaints in the United States. One out of every three adults has hypertension, so approximately a third of your entire patient base may be on one or more of the above. These medications do have xerostomia as a side-effect, and as with the preceding items on this list, often come in combination with negative lifestyle traits that increase caries risk.
Antidepressants have recently been implicated in having negative effects on bone health. Any medication that compromises the bones compromises the teeth as well. Reduced gingival attachment, candidiasis, and implant failure have all been associated with antidepressant side-effects. On top of this, antidepressants (you guessed it!) also can cause xerostomia.
We all have a patient who gets hives if you so much as look at them wrong, and every year Americans spend $4.5B on medication and doctor’s visits to address their allergies. Not only do many of the medications cause xerostomia due to their anticholinergic action, allergy sufferers often sleep with their mouth open due to blocked sinuses, increasing their caries risk.
High Blood Pressure Facts | cdc.gov. (2018). Cdc.gov. Retrieved 9 January 2018, from https://www.cdc.gov/bloodpressure/facts.htm
5 Medications That May Be Causing Your Teeth to Decay. (2018). Guardian Dental Insurance Plans. Retrieved 9 January 2018, from https://mydental.guardianlife.com/blog/2017/06/7-medications-that-may-b…
The information contained in this, or any case study post in Incisor should never be considered a proper replacement for necessary training and/or education regarding adult oral conscious sedation. Regulations regarding sedation vary by state. This is an educational and informational piece. DOCS Education accepts no liability whatsoever for any damages resulting from any direct or indirect recipient's use of or failure to use any of the information contained herein. DOCS Education would be happy to answer any questions or concerns mailed to us at 106 Lenora Street, Seattle, WA 98121. Please print a copy of this posting and include it with your question or request.