Oral Medication & Your Health

Oral Medications and Your Dental Health

Some of the nations top oral medicine experts presented a symposium at the most recent American Dental Association Annual Session. The information they reported concerned the serious dental side effects that our most common prescription and non prescription drugs can cause. I felt this information would be beneficial to help you avoid complications for both you and your loved ones.

In past columns I have cautioned you to report to your dentist any and all medications you are taking. It is important to keep your dentist continually updated on any additions or changes in your medications, including over the counter drugs. This is extremely important as doctors reported that literally hundreds of medicines that Americans take everyday, from the countries most popular blood pressure medication to chewable antacids, can cause serious tooth decay and gum disease.

Dr. Sebastian Ciancio, a dentist and pharmacologist at the University of Buffalo, also cautions about taking your medication as prescribed. He related an incident in which an elderly patient presented with tooth decay, " like (Dr. Ciancio) has never seen before... a large black hole on the outside of one of his front teeth". Upon Questioning the patient Dr. Ciancio discovered the decay was caused by the way in which the man was taking his heart medication. It seems the patient would gag when he put his nitroglycerine tablets under his tongue, so he decided to stick them under his top lip. The tablets then proceeded to eat a hole in his tooth. In previous columns I have addressed some of the concerns voiced by this panel such as the high levels of sugar found in childrens medications. The panel also cautioned that many throat lozenges, cough drops, antacids and other non-prescription drugs are loaded with sugar.
Over the years I have discussed the serious effects of xerostomia or dry mouth on the oral tissues. Lack of saliva leads to excess plaque, cavities and fungal infections. The panel reported that in addition to radiation therapy there are over 400 drugs that can cause dry mouth.

Some of the chief concerns the experts presented included:

  1. Up to 20% of patients taking calcium channel blockers for high blood pressure and heart disease suffer gum swelling. The inflammation opens pockets into the gums for bacteria to infiltrate, leading to massive swelling and serious gum disease. These medications include some of the nations best selling drugs including Procardia, Cardizem and Adalat.

  2. Similar swelling is caused by anti--epilepsy drugs particularly Dilantin, and some amphetamines used to treat hyperactivity in children.

  3. Cyclosporin, Used by organ transplant recipients to prevent organ rejection can cause an even more massive gum overgrowth. It's  appearance can also resemble the gum inflammation caused by leukemia.

Dentists have to look very carefully at the medications their patients take.

Many side effects can be prevented with a concerted effort at preventative care. Depending on what the patient presents to his dentist with or how extensive the damage, this may result in extra cleanings, oral surgery and/or working with the physician to find an acceptable alternative medication regime.

Dr. Stephen Petras

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