The medications you take—prescription, over the counter and herbal remedies—can affect your mouth in a myriad of ways. Talking to your dentist, knowing the side effects linked to your prescription and taking good care of your oral health can help you deal with side effects from dry mouth to ulcers.
The number one side effect of medications is dry mouth, or xerostomia. “This can be significant,” says Dr. Christopher Lee, an assistant professor at the Faculty of Dentistry at Dalhousie University in Halifax. “Saliva has a lot of effects in helping you chew and swallow. It also prevents the tearing of gums.”
In addition, he notes, when your mouth is dry, dentures may not stay in place as well and you have an increased risk of cavities. “Saliva washes away the bacteria that causes cavities. Those with less saliva tend to have more cavities.”
There are options to alleviate the discomfort and the risk posed by xerostomia. Some are simple and straightforward: carry water to drink, suck on sugar-free hard candy or chew sugarless gum. There are also saliva substitutes, but they aren’t as effective as natural saliva in your mouth. Dr. Lee also notes that there are medications to increase saliva production but these, too, come with their own side-effects.
Warfarin, a blood thinner used to reduce the risk of stroke, can cause excessive bleeding of gums. Herbal remedies can also cause bleeding. “People have had to be transfused after an extraction,” says Dr. Lee, noting the seriousness of some of these situations. Another side effect of some medications can be gingival hyperplasia. Calcium channel blockers often used to treat cardiac conditions (such as nifedipine, diltiazem, and verapamil), some anti-seizure medications (such as phenytoin), and some immunosuppressants (such as cyclosporine A) can cause the gums to become enlarged and appear puffy. The condition is generally not painful, though if not kept properly clean, the gums can become irritated or infected. “You can undergo surgery to remove overgrown gums, but they’ll grow back,” says Dr. Lee.
Many people take these types of medications to address life-threatening conditions like high blood-pressure, so stopping the prescription is not an option. Luckily, having good oral health tends to lessen the side-effects. Brushing and flossing regularly is important as is using a soft-bristle tooth brush. Talking to your dentist is also essential. Solutions can usually be found to many medication-related problems. “We will see more of these issues as the general population ages,” notes Dr. Lee.
It’s not only adults who encounter problems. Parents may sometimes find their children’s teeth become stained, sometimes permanently, as a result of antibiotics like tetracycline, which is no longer recommended for pregnant women or children under eight years old. Amoxicillin, an antibiotic commonly used to treat babies’ ear infections, has also been linked to tooth enamel problems, but the stains it can cause usually fade.
Another side-effect of many medications is taste alterations. Some antibiotics, for example, can leave you with a metallic taste, but this goes away once you stop taking the drug.
Chemotherapy drugs can lead to dry mouth, taste alterations, pain, ulcers and fungal infections, while long-term use of antipsychotics can cause uncontrolled movement of the lips and mouth.
Many people, of course, take more than one medication, which can compound problems. “Every medication has an effect on another medication. The side effect may be the result of a combination of drugs,” says Dr. Lee. “You don’t want to play roulette. The first course of action is always to manage the side-effect.”
To do that your dentist needs to understand what medications you have been prescribed along with any supplements, vitamins and herbal remedies you use. “Tell your dentist what you are taking and why,” says Dr. Lee. “Together you can explore solutions that will work for you.”