Friday, April 4, 2014

Medication Effects on Teeth, A Dental View

dental decay cavities drugs


There are unfortunate (sometimes emergency) cases where one can sustain a traumatic and inadvertent injury to the dentition and oral cavity.   Such dental trauma may also stem from a medical or pharmacological condition, such as a drug's side effect or due to a body's physical condition.
A cursory understanding of medical conditions, diseases, and side effects from drugs will help one see how said conditions relates from a dental point of view, and also allows one to see how the body and the oral cavity, teeth, and gums inter-relate with one another.

Let's examine some possible dental and teeth damage due to various medical conditions:
1) Xerostomia 2) Sjogren's syndrome 3) Bulimia and Gastroesophageal reflux disease 4) Methadone side effect 5) Recreational drug use side effect 6) Medication side effects 7) Chemotherapy and radiation


Xerostomia, or dry mouth, can be due to aging, immunosuppressive medications, prescription medications, and chemical and radiation therapy.  With dry mouth saliva production is lowered, placing the teeth at higher risk of dental decay, necessitating the need for tooth colored fillings (resins).
Medications are many but can include antihypertensives, antidepressnats, diuretics, steorids, anticonvulsants, antianxiety agents, antipsychotics, and acne treatments.


Sjogren's Syndrome is an autoimmune disorder that is characterized by excessive antibody production that are directed against certain tissues in the body.  Gland inflammation is a distinct characterization of Sjogren's, and affects the lacrimal glands in the eyes and also causes inflammation of the salivary glands.  The affected glands result in decreased tear production in the eyes and decreased saliva production in the mouth, hence dry eyes and dry mouth and lips are key indicators of this Sjogren's Syndrome.  With dry mouth dental decay may be more prevalent and may require tooth colored fillings to restore the dentition. 


Bulimia is a psychologically induced condition where vomiting is forced and self-induced. Patients have tremendous fear of weight gain and have a severe negative overweight image of their bodies, thus forcing themselves to vomit in order to lose weight .  Hence the teeth are constantly exposed to acids in the stomach, if untreated can lead to enamel erosion and deterioration, which can then affect the dentin.  Tooth colored fillings or porcelain crowns may be required.


Methadone, a prescription medication by one's physician, is used as an anti-addictive medication for opioid addiction (ie. oxycodone, hydrocodone), and may also be used as an analgesic and antitussive. 
Methdaone's damage on the teeth can be extremely extensive, from enamel and dentin erosion to teeth fracture.  Such cases often require extensive dental treatment including porcelain crowns, surgical tooth extractions, and dental implants.


Methamphetamine is a recreational drug when taken due to dependence, can cause severe teeth erosion and rampant dental decay / cavities.  Dental fillings, root canals, and porcelain crowns may be required in such cases to restore the dentition. 


Tetracycline is an antibiotic, when taken during tooth formation, can cause malformations of the teeth.  Malformations may range from relatively minor enamel striations to complete enamel discoloration and dentin weakness, causing eventual tooth failure and fracture.  If the effects are minor, treatment may not be required.  If the effects are major, dental treatments may include porcelain veneers, dental crowns, and/or root canal therapy.


Chemotherapy and radiation, commonly used for cancer treatment, can negatively affect salivary production and thus cause dry mouth, which increases one's risk of tooth decay and gum disease.  Common dental affects may include rampant and extensive cavities and swollen & bleeding gums.  Patients undergoing chemotherapy and radiation may thus be at increased need of fillings.


It is this author's hope that after reading this blog, one will have a little more appreciation of the negative side effects of various drugs and medical treatments on the oral dentition.  While in most cases dental treatment can be rendered to address aforementioned negative effects on the dentition, a close relationship between the patient's dentist and physician is necessary to control and maintain the drug side effects, and to prevent the drug from overpowering teeth and periodontal health.

From your family Bellevue dentist,
Dr. Peter Chien
(425) 614-1600