Medications That Affect Teeth & Gum Health

Medications & Oral Health

Prescription and over-the-counter (OTC) medications can negatively impact your general and dental health.

Common dental health problems that can occur as a side effect of everyday medications include:

• Abnormal bleeding
• Changes in taste
• Soft-tissue reactions (i.e., mouth ulcers)
• Dry mouth
• Exposed bone
• Swollen gum tissue
• Tooth decay
• Gingival overgrowth

How Do Medications Affect Dental Health?

It’s important to tell your dentist which medications you’re taking to ensure you receive the best care possible. 

For example, certain SSRIs can increase the likelihood of developing bruxism (habitual teeth grinding and jaw clenching). Bruxism can be at the root of many dental problems and is diagnosed during a professional dental exam.

Some stimulant medications can also alter the processing of neurotransmitters by the central nervous system. With long-term use, this can lead to a reduction in saliva production (dry mouth), which causes tooth decay and gum disease.

If you have chronic conditions or illnesses, inform your dentist before or during your next appointment.

Medications That Cause Common Oral Health Issues

Taking any medication comes with the risk of side effects, some of which relate to oral health. These side effects can include:

• Dry mouth
• Oral thrush
• Tooth decay and cavities
• Gum swelling
• Gingival overgrowth
• Mouth ulcers
• Changes of taste
• Abnormal bleeding
• Exposed bone

Some of these diseases are harmless, while others can indicate more serious health conditions.

Dry Mouth

Dry mouth, also known as xerostomia, is an uncomfortable side effect of certain medications that commonly affects older adults.

Xerostomia is an oral condition in which the salivary glands in the mouth don’t produce enough saliva to keep the mouth wet.

Saliva is essential for cavity protection because it repairs tooth enamel through remineralization and removes plaque. As saliva production decreases, oral dryness is more likely to occur, which can result in tooth decay or tooth loss.

Untreated xerostomia can lead to bad breath, gum disease, and painful mouth sores. It can also cause dental erosion, a chemical process that results in the loss of dental tissue.

Most Common Medications That Cause Dry Mouth

Many medications can cause xerostomia, either as a direct side effect or as the consequence of a side effect (such as bruxism).

The most common drugs that may result in the condition include:

• Antidepressants — Most antidepressants are used to treat depression. Popular antidepressants include Celexa, Wellbutrin, Paxil, Prozac, and Savella.
• Muscle relaxers — These medications treat muscle spasms and discomfort. Popular muscle relaxants include Robaxin, Somas, and Flexeril.
• Decongestants — These over-the-counter medications reduce allergy symptoms. Common brands of decongestants include Afrin, Sudafed, and Vicks.
• Diuretics — These medications are also called “water pills.” They’re commonly used to help treat high blood pressure.
• Antihistamines — Medications that stop allergy symptoms, including hay fever, flu symptoms, and food allergies.
• Appetite suppressants — Over-the-counter medications that reduce appetite and decrease food consumption.
• Blood pressure medications — Including diuretics, beta-blockers, alpha-blockers, and calcium channel blockers, among others.
• Chemotherapy medications — These can cause xerostomia, gum problems, oral inflammation, and tooth decay.
• Opioids — These can cause xerostomia and tooth decay.

Other Medications That Can Cause Dry Mouth

There are many medications, not necessarily prescription drugs, that can cause xerostomia. 

Examples include:

• Narcotic pain medications
• Certain acne medications (like Isotretinoin)
• Antipsychotics
• Medications for Parkinson's and Alzheimer's disease
• Seizure medications
• Anti-spasm medications
• Scopolamine (for motion sickness)
• Respiratory inhalants for asthma (like albuterol, epinephrine, and levalbuterol)

How to Promote Saliva Production to Combat Dry Mouth

Saliva helps prevent cavities and xerostomia and chewing gum is a great way to stimulate saliva production. However, you'll need to ensure the gum is sugar-free to not inadvertently feed the cavity-causing bacteria.

The best chewing gum for fighting cavities is one containing the sweetener xylitol. Xylitol is a plant-based sugar substitute that kills bacteria in the mouth.

Oral Thrush

Oral thrush (oral candidiasis) is a yeast infection that forms due to the overgrowth of Candida fungus that lives in the mucous membrane lining of the mouth.

Most people have small traces of Candida in their mouths. For some, the fungi can overgrow and cause thrush. If you have a strong immune system, the fungus doesn’t overgrow.

The most common indication of thrush is creamy white lesions that wipe off and leave a red, raw base. These lesions can also develop on the palate, tongue, lining of the cheeks, or back of the lips.

Medications That Cause Oral Thrush

If you’re taking medications that increase your risk for dry mouth, oral thrush can develop over time.

Medications that can also cause thrush include:

• Certain antibiotics — These include penicillin, cephalosporin, and tetracycline.
• Inhaled steroids — These are prescribed to people with asthma (e.g., inhalers).
• Prednisone — Medications that treat blood disorders, arthritis, breathing issues, chronic allergies, cancers, skin diseases, eye problems, and immune system illnesses.

Tooth Decay and Cavities

There are plenty of prescription drugs around that cause dental problems, including tooth decay, as a side effect.

The medications that cause dry mouth as a side effect often also cause cavities, as there’s a high degree of interconnectivity between the two conditions. 

Medications That Can Cause Tooth Decay

The pharmaceutical drugs that can produce side effects specifically impacting tooth enamel  include:

• Asthma medications — These medications can be highly acidic and dissolve tooth enamel over time if used regularly.
• Aspirin — Chewing aspirin can damage tooth enamel because it is acidic.
• Antacids — These medications are also highly acidic.
• Opioids — These can cause dry mouth and tooth enamel erosion.
• Decongestants and antihistamines — These can cause dry mouth and cavities.
• Blood pressure medications — These can cause dry mouth and cavities.
• Antidepressants — These can cause dry mouth and cavities.

Medications That Contain Sugar

Cough drops, chewable vitamins, syrups-based medications, and other liquid medications often contain sugar. The long-term use of medications with sugar can result in tooth decay.

If possible, switch to sugar-free alternative medications to help prevent tooth decay (especially in children).

Brushing with fluoride toothpaste twice a day and flossing regularly is essential. You should also visit the dentist for professional teeth cleanings every six months.

Gum Inflammation

Certain prescription medications are linked to mouth sores, tissue discoloration, and gum inflammation.

Contact your dentist immediately if you experience soft-tissue inflammation after taking any of these medications. He or she can then create a custom oral hygiene regimen to help decrease discomfort and symptoms.

Medications That Can Cause Gum Inflammation

Medications that may cause oral ulcers and/or inflammation in the mouth include the following:

• Blood pressure control medications — These medications include diuretics, beta-blockers, alpha-blockers, and calcium channel blockers, among others.
• Immunosuppressive agents — These drugs suppress the immune system and decrease the rejection of transplant organs.
• Oral contraceptives — Birth control pills contain estrogen and progestin, which can increase inflammation in the body.  
• Chemotherapy — Chemo treatment can result in dental health complications, including soft-tissue reactions in the mouth. Dry mouth is also common. 

Chemotherapy and Oral Health Risks

Chemotherapy (chemo) is the most widely-used cancer treatment, using a cocktail of chemicals and immunosuppressant drugs to kill cancer cells. There are many negative side effects of chemo.

Hair loss, weight loss, vomiting, and nausea are common side effects.

Chemotherapy treatment can also cause a variety of dental health side effects, including:

• Dry mouth
• Changes in taste
• Cavities (tooth decay)
• Bone disease
• Increased risk for gum inflammation and infection
• Pain and inflammation inside the mouth
• Difficulties chewing, speaking, and swallowing
• Mouth sores

Tips for Reducing Oral Health Risks at Home

If you take any medications that can cause dry mouth or tooth decay, follow these tips to reduce your chance of oral disease:

• Drink eight to 10 glasses of water a day
• Get regular teeth cleanings and dental exams
• Chew sugarless gum to promote the production of saliva
• Kick sugar or eat sugarless candy
• Don’t use tobacco products or smoke
• Drink less caffeine
• Drink less dehydrating drinks (tea, alcohol, etc.)
• Eat more healthy and hydrating snacks (vegetables, celery, fruit, etc.)
• Brush and floss your teeth regularly
• Use a hydrating mouth spray and/or mouth rinse

One of the best ways to reduce your chances of developing dental health issues from medication is to take preventative measures in your diet.

You can drink chamomile, lavender, and valerian tea or turmeric milk to help relieve the symptoms of bruxism. 

Common Questions About Oral Health and Medications

Which antidepressants cause dental health problems?

In addition to dry mouth, bruxism (habitual teeth grinding and jaw clenching) is one of several dental health issues SSRI use can cause. It's most common in women and children.

Bruxism can lead to dental problems, including jaw pain, tooth damage, and tooth sensitivity.

Herbal medications that you can use to treat bruxism include:

• Chamomile, lavender, or valerian tea in the evening before bed
• Valerian or lavender essential oils in a diffuser or as a massage oil on your jaw
• Turmeric milk (a combination of milk for its tryptophan amino acid and turmeric for its anti-inflammatory properties) at least 30 minutes before bed

Does Flexeril work for tooth pain?

Flexeril is a muscle relaxant that you shouldn’t use to treat tooth pain. If you feel pain in your tooth, it may be due to problems with the nerve.

A dentist, however, may prescribe Flexeril to a person experiencing jaw tension to help relax the jaw muscles. This may have the effect, inadvertently, of relieving any tooth pain that’s the result of jaw clenching.

Does high blood pressure medication affect your teeth?

Some high blood pressure medications, like calcium channel blockers, can cause gum overgrowth.

Inflamed gum tissue can mean extra room for bacteria to grow underneath the gum line. Gingivitis, when left untreated, can progress into periodontal disease.  

Periodontal disease is a serious inflammation of the gum tissue that can lead to periodontitis, which can result in enamel loss and gum recession to the extent of complete tooth loss.