Medications are supposed to make you healthier, but sometimes the side effects have negative impacts on your teeth and oral health.
Over 50% of Americans are taking one or more prescription drugs¹. Blood pressure medication, cholesterol-reducing medication, and medication to treat hypothyroidism were the most frequently used².
Though medications rarely may have the direct effect of tooth decay, many medications have the shared common side effect of xerostomia or dry mouth. Dry mouth is a common factor, which may lead to tooth decay and infection from a bad cavity³.
Drying irritates the soft tissues in your mouth, which may 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, typically your risk for infection and tooth decay is increased.
Here are the common medications which may cause dry mouth and subsequent tooth decay, and what you can do to help 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 health⁴.
Antacids may 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 may be dangerous to your teeth, as they can get stuck between your teeth and after prolonged exposure, may 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 which may lead to erosion of tooth enamel⁵.
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 mouth⁶.
Decongestants are another common treatment for allergies and the common cold which can also create dry mouth.
Decongestants like cough syrups may create another level of damage to the teeth in that they’re highly acidic, which, like antihistamines, can lead to tooth decay and discoloration⁷.
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 typically share the side effect of dry mouth, which may increase your chances of developing tooth decay⁸.
Antidepressants have been linked to negative effects on bone health⁹, which may increase a person’s chances of developing tooth decay, bad breath, gum disease, oral yeast infections and implant failure. On top of this, antidepressants also cause dry mouth¹⁰.
How to minimize damage
When thinking about how to treat cavities it is important to note that the more effective way to treat a cavity is to prevent one in the first place. If you take regular pain medication, you can help curb dry mouth and consequential tooth decay by following these common regiments:
Increase your daily water intake by drinking at least eight to ten glasses of water a day.
Brush your teeth twice a day.
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.
It is important to be aware of the signs of a cavity, such as tooth pain, tooth sensitivity, and blackened areas on a tooth, and see a dentist regularly¹¹. For the bad breath which often accompanies dry mouth, in consultation with your doctor, 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 help minimize the damage of acid reflux on your teeth, try to avoid foods that trigger heartburn and acid reflux, such as the following:
Alcohol (particularly red wine)
Citrus fruits and juices
Coffee and caffeinated drinks
In consultation with your doctor, 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)
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)
Healthy fats (avocados, walnuts, flaxseed, olive oil, sesame oil and sunflower oil)
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https://www.kff.org/health-costs/poll-finding/public-opinion-on-prescription-drugs-and-their-prices/ (June 2021) Accessed August 2021
https://www.drugreport.com/50-commonly-prescribed-drugs-in-america/ (2020) Accessed 7/8/2021
https://www.nidcr.nih.gov/health-info/dry-mouth Accessed August 2021
https://www.mouthhealthy.org/en/az-topics/e/tooth-erosion-and-acid-reflux Accessed August 2021
https://www.cdc.gov/drugoverdose/pdf/AHA-Patient-Opioid-Factsheet-a.pdf Accessed August 2021
https://www.mayoclinic.org/drugs-supplements/antihistamine-oral-route-parenteral-route-rectal-route/precautions/drg-20070373 (August 2021) Accessed August2021
https://www.huetdental.com/how-treating-a-cold-can-cause-cavities/ (January 2020) Accessed August 2021
https://www.fda.gov/consumers/free-publications-women/high-blood-pressure-medicines-help-you (February 2021) Accessed August 2021
https://agsjournals.onlinelibrary.wiley.com/doi/full/10.1111/jgs.16729 (August 2020) Accessed August 2021
https://www.healthgrades.com/right-care/oral-health/10-medications-that-cause-dry-mouth (March 2021) Accessed August 2021
https://crest.com/en-us/oral-health/conditions/cavities-tooth-decay/cavities-tooth-decay-symptoms-causes-treatment Accessed August 2021
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.10/23)