Medications That Affect Teeth & Gum Health

Medications & Oral Health

Prescription and over-the-counter medications can negatively impact your general and oral health.

Common complications associated with everyday medications include irregular bleeding, changes in taste, soft-tissue reactions (sores), dry mouth, and enlarged gum tissue.

During routine dental exams, it is important to tell your dentist which medications you are taking to ensure you receive the best care possible.

If you currently have any chronic conditions or illnesses, let your dentist know before or during your next appointment.

Common Oral Health Conditions Caused By Medications

Dry mouth, gum inflammation, mouth sores, cavities, and oral thrush are common conditions associated with many medications.

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

Medications That Cause Dry Mouth

Medication-induced dry mouth is an uncomfortable side effect that impacts many older adults.

Dry mouth (xerostomia) is an oral condition when the salivary glands in the mouth do not produce enough saliva to keep the mouth wet.

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

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

There are thousands of everyday medications that can cause dry mouth. The most common prescription meds that may result in xerostomia include the following:

  • Antidepressants — most types of 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 are 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 (vitamins) that reduce appetite and decrease food consumption.
  • Blood Pressure medications — including diuretics, beta-blockers, alpha-blockers, and calcium channel blockers, among others.
  • Chemotherapy medications — can cause dry mouth, gum problems, oral inflammation, and tooth decay.
  • Opioids — can cause dry mouth and the erosion of tooth enamel.

Other medications that can cause dry mouth include:

  • Lung inhalers
  • 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)

Medications That Affect The Gums

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

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

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 — drugs that 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 oral health complications, including soft-tissue reactions in the mouth. Dry mouth is also common. 

Medications That Cause Oral Thrush

Oral thrush (oral candidiasis) is a yeast infection that forms due to the overgrowth of Candida fungus that lives in the mucous membranes lining in 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 does not overgrow.

The most common sign of thrush is white spots (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.

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

Other medications that can also cause thrush include:

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

Medications That Cause Tooth Decay

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

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

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

Other medications that can affect teeth health include:

  • Asthma medications — these meds 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 meds are also highly acidic.
  • Opioids — can cause dry mouth and tooth enamel erosion.
  • Decongestants and antihistamines — can cause dry mouth and cavities.
  • Blood pressure medications — can cause dry mouth and cavities.
  • Antidepressants — can cause dry mouth and cavities.

Chemotherapy and Oral Health Risks

Chemotherapy (chemo) is the most widely used cancer treatment that uses chemicals to kill cancer cells. However, there are many negative side effects of chemo.

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

Chemo can also cause a variety of oral health side effects, including:

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

Tips: How to Reduce Oral Health Risks

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 ten glasses of water a day
  • Get regular teeth cleanings and dental exams
  • Chew sugarless gum
  • Kick sugar or eat sugarless candy
  • Do not 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

Chewing gum stimulates the production of saliva, and saliva is a great cavity fighter. However, you'll need to make sure the gum is sugar-free so that you’re not inadvertently feeding 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.

Acid reflux (heartburn) can also damage your teeth and cause acid erosion. To reduce these effects, avoid or limit foods that trigger heartburn:

  • Alcohol
  • Raw onions
  • Spicy foods
  • Citrus fruits and juices
  • Black pepper
  • Tomatoes
  • Garlic
  • Chocolate 
  • Caffeine (e.g., coffee, black tea, etc.)
  • Peppermint

Resources

American Dental Association (ADA). June 2005. How Medications Can Affect Your Oral Health. https://www.ada.org/~/media/ADA/Publications/Files/patient_51.pdf?la=en

Brecher, Erica. ADA Dental Drug Handbook: a Quick Reference. American Dental Association, 2019.

“Dental and Oral Health.” Cancer.Net, 22 July 2019, https://www.cancer.net/coping-with-cancer/physical-emotional-and-social-effects-cancer/managing-physical-side-effects/dental-and-oral-health.

Ichikawa, Kana, et al. “Relationships between the Amount of Saliva and Medications in Elderly Individuals.” Wiley Online Library, John Wiley & Sons, Ltd, 2 June 2010, onlinelibrary.wiley.com/doi/abs/10.1111/j.1741-2358.2009.00358.x.

Rubin, B K, and M Simunovic. “Medication Caries: Another Form of ‘Snacking.’” Canadian Family Physician Medecin De Famille Canadien, U.S. National Library of Medicine, Apr. 1989, www.ncbi.nlm.nih.gov/pmc/articles/PMC2280819/.

Tan, Edwin C. K., et al. “Medications That Cause Dry Mouth As an Adverse Effect in Older People: A Systematic Review and Metaanalysis.” American Geriatrics Society, John Wiley & Sons, Ltd, 26 Oct. 2017, agsjournals.onlinelibrary.wiley.com/doi/full/10.1111/jgs.15151.

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