5 Medications That Can Cause Tooth Decay | Guardian Direct

5 medications that may be causing your teeth to decay

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Here are common medications that cause dry mouth and tooth decay and how to protect your oral health.

Medications are supposed to make you healthier, but sometimes the side effects have negative impacts on your teeth and oral health.

Nearly 50% of Americans used one or more prescription drugs in the past 30 days.¹ Asthma medication, stimulants to treat attention deficit disorder and antidepressants were the most frequently used.²

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Dry mouth

Though medications rarely have the direct effect of tooth decay, all the medications listed above (and more) have the shared common side effect of xerostomia or dry mouth. Dry mouth is a common factor, which can lead to tooth decay and infection.³

Drying irritates the soft tissues in your mouth, which can make them inflamed and heighten your risk for infection. Saliva plays a big role in protecting your teeth from bacteria. So when your mouth is dry, your risk for infection and tooth decay is increased.

Here are the common medications which cause dry mouth and subsequent tooth decay, and what you can do to protect your oral health.


Though the acid from heartburn and acid reflux can lead to tooth erosion, treating these conditions with antacids can also be bad news for your oral health.⁴ 

While antacids reduce tooth-damaging acid in your mouth, antacids can weaken your teeth and contribute to tooth decay. This risk is applicable to chewable, dissolvable and liquid antacids. 

Antacids also may contain sugar or other tooth-damaging artificial sweeteners. Chewable antacids are especially dangerous to your teeth, as they can get stuck between your teeth and after prolonged exposure, can result in cavities.

Pain medications that may cause tooth decay

Patients with chronic pain are especially prone to periodontal disease and losing teeth due to dry mouth brought on as a side effect of pain medications. Opioids, which are sometimes prescribed to treat pain, are also guilty of causing dry mouth and the consequent erosion of tooth enamel.⁵ 

Antihistamines and decongestants

Antihistamines block histamine receptors to prevent allergic reactions. However, this same effect happens in other areas of the body, including the mouth and tongue. Antihistamines block the release of saliva, which results in dry mouth.⁶

Decongestants are another common treatment for allergies and the common cold which can also create dry mouth.

Cough syrups create another level of damage to the teeth in that they’re highly acidic, which, like antihistamines, can lead to tooth decay and discoloration.⁷

Blood pressure medication

Beta-blockers, calcium channel blockers, diuretics, heart rhythmic medications and angiotensin-converting enzyme inhibitors are all commonly prescribed to treat high blood pressure. These medications all share the side effect of dry mouth, increasing your chances of developing tooth decay.⁸


Antidepressants have been linked to negative effects on bone health⁹, which can increase a person’s chances of developing rampant tooth decay, bad breath, gum disease, oral yeast infections and implant failure. On top of this, antidepressants also cause dry mouth.¹⁰

How to minimize damage

If you take regular pain medication, you can help curb dry mouth and consequential tooth decay by following these regiments:

  • Increase your daily water intake by drinking at least eight to ten glasses of water a day.

  • Brush your teeth twice a day.

  • Go for regular dental check-ups and cleanings.

  • Use a moisturizing mouth spray. 

  • Eat hydrating snacks like celery sticks.

  • Chew sugarless gum or suck on sugarless candy.

  • Don’t use tobacco products.

  • Cut back on caffeinated and dehydrating drinks like coffee, tea, and alcohol.

  • Try a hydrating mouth rinse.

For the bad breath which often accompanies dry mouth, you may want to try chewing on any of the following herbs: parsley, aniseed, fennel or rosemary.

When you do reach for the antacids to treat heartburn or acid reflux, find a sugar-free option. Be sure to brush your teeth after taking an antacid to help reduce any damaging effects.

To minimize the damage of acid reflux on your teeth, try to avoid foods that trigger heartburn and acid reflux, such as the following:

  • Spicy foods

  • Alcohol (particularly red wine)

  • Black pepper

  • Garlic

  • Raw onions

  • Chocolate

  • Citrus fruits and juices 

  • Coffee and caffeinated drinks

  • Peppermint

  • Tomatoes

Add the following foods to your diet to help reduce the occurrence of heartburn and acid reflux:

  • Vegetables (green beans, broccoli, asparagus, cauliflower, leafy greens, potatoes and cucumbers)

  • Ginger 

  • Oatmeal

  • Whole-grain bread and whole-grain rice

  • Non-citrus fruits (melons, bananas, apples and pears)

  • Lean meats (chicken, turkey, fish and seafood grilled, broiled baked or poached — avoid fried meat)

  • Egg whites

  • Healthy fats (avocados, walnuts, flaxseed, olive oil, sesame oil and sunflower oil)


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  1. https://www.cdc.gov/nchs/fastats/drug-use-therapeutic.htm (Last accessed September 2019)

  2. https://www.bloomberg.com/news/articles/2019-05-08/nearly-one-in-two-americans-takes-prescription-drugs-survey (Last accessed September 2019)

  3. https://www.mayoclinic.org/diseases-conditions/dry-mouth/symptoms-causes/syc-20356048 (Last accessed September 2019)

  4. https://www.mouthhealthy.org/en/az-topics/e/tooth-erosion-and-acid-reflux (Last accessed September 2019)

  5. https://www.cdc.gov/drugoverdose/pdf/AHA-Patient-Opioid-Factsheet-a.pdf

  6. https://www.ada.org/~/media/ADA/Publications/Files/patient\_51.pdf?la=en

  7. https://www.ada.org/~/media/ADA/Publications/Files/patient\_51.pdf?la=en

  8. https://www.fda.gov/consumers/free-publications-women/high-blood-pressure-medicines-help-you (Last accessed September 2019)

  9. https://www.fda.gov/consumers/free-publications-women/high-blood-pressure-medicines-help-you (Last accessed September 2019)

  10. https://www.ada.org/~/media/ADA/Publications/Files/patient_51.pdf?la=en (Last accessed September 2019)

Brought to you by The Guardian Life Insurance Company of America (Guardian), New York, NY. Material discussed is meant for general illustration and/or informational purposes only and it is not to be construed as tax, legal, investment or medical advice.(exp.09/21)

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