Dry Mouth Medications: A Recipe for Tooth Decay

Many prescription pills will cause xerostomia or dry mouth - dentist in Orange, CT

Is this causing dry mouth?

Many older patients in our practice in Orange, CT take medications as part of their daily routine.  However, many of these prescription drugs have an unwanted side effect: dry mouth, more formally called xerostomia.

In fact, the most commonly prescribed medication in the United States in 2012 lists xerostomia a common side effect!

Chronic dry mouth can have a profound effect on the oral cavity, leading to dental decay (cavities) as well as inflammation of the gum tissue.

Without treatment, the results of the dry mouth can be devastating: loss of some or all of your teeth!

Photo of Tooth Decay from Dry Mouth

Photo of teeth with decay from dry mouth or xerostomia from radiation treatment

Teeth with decay (cavities) from chronic dry mouth on a patient from Woodbridge, CT. Photo and subsequent treatment by Dr. Nicholas Calcaterra.

The above photo shows quite dramatically the decay (also known as cavities) that can occur due to dry mouth. We see decay both at the gum line as well as near the edges or tips of the teeth. This is the classic pattern of decay due to xerostomia.

Common Drugs which Cause Xerostomia

Medications and Drugs which cause dry mouth xerostomia leading to dental decay and cavities

The most widely prescribed drug in the U.S. is associated with dry mouth!

Older adults take many medications which can lead to dry mouth. Some of them include:

  • Medications for high blood pressure: ACE inhibitors, Angiotensin II Receptor Blockers, Diuretics, and others.
  • Anti-cholinergic medications used to treat a variety of conditions.
  • Many anti-depressant medications (Zoloft, Celexa, etc.).
  • Narcotic based pain relievers such as Vicodin and Percocet.

As previously mentioned, the most commonly prescribed pain medication in 2012 was Vicodin and is associated with xerostomia.

Why Dry Mouth Leads to Tooth Decay

Saliva has numerous qualities which help to reduce decay and gum disease. A partial list includes:

  • Contains buffers which help to neutralize acids from foods (soda, candy, fruits, etc.)
  • Possess several anti-microbial proteins which kill harmful bacteria.
  • Serves to mechanically cleanse and remove food debris.
  • Helps to remineralize damaged tooth structure.
  • Any many other functions.

As you can imagine, if the amount of saliva is reduced, the normal benefits of saliva are not realized.

photograph and picture of cavities from dry mouth with ropey saliva

Another photo of dental decay from chronic dry mouth from medications. This patient was from West Haven, CT. Photo and subsequent treatment by Dr. Nicholas Calcaterra.

Treatment for Chronic Xerostomia

Our patients are on medications for important reasons, so we can’t have them discontinue the medications solely because of the effects of dry mouth. But there are several options for either increasing the amount of saliva and/or protecting the teeth. These include:

  • High fluoride content toothpastes and rinses to reduce the likelihood of further tooth decay. An example is Prevident.
  • Chewing xylitol based gum. The chewing action stimulates salivary flow and the xylitol is proven to reduce tooth decay.
  • Various toothpastes, mouthrinses, gels and other products designed solely to moisten the soft tissue and help your mouth feel wetter. The products from Biotene are the most common.
  • Sucking on sugar free candies throughout the day, stimulating saliva flow.

You should work with your dentist and physician to determine if your medications are causing dry mouth and if so, the degree to which the dryness is affecting your overall oral health. From there, the appropriate treatment (if any) can be recommended.

 

NYU Study Confirms Link Between Tooth Loss and Pregnancy

Pregnant Woman Photo who will lose more teeth and have more dental problems

Expectant Mom. Will she expect to lose teeth?

A study out of New York University’s Dental program has given validity to the saying “for every child, the mother loses a tooth.”

In this research, Professor Stefanie Russell looked at women ages 18 to 64 who reported at least one pregnancy. After controlling for numerous variables, Russell demonstrated that women with more children were more likely to have more missing teeth.

In our experiences treating hundreds of present and future Moms in our Orange, CT dental office, we found the study results to be consistent with our observations. Changes in oral health in pregnant women are often times first detected in routine dental hygiene visits by our Hygienists Crystal and Toni. Then we end up observing dental problems during the later phases of the pregnancy and then after childbirth.

How Pregnancy Affects Teeth and Gums

As any mother would attest, pregnancy affects every part of the mom-to-be’s life.  The teeth and gums are no exception. We’ve made the following observations over the years:

Photo of tooth with dental decay on pregnant patient Woodbridge, CT

Cavity on a post-partum patient from Milford, CT

  • Hormonal changes cause the gum tissue to be more sensitive to plaque, leading to pregnancy gingivitis. Pregnancy Gingivitis is generalized inflammation of the gum tissue. Routine dental cleanings during pregnancy are needed to treat this.
  • Morning sickness can lead to nausea and vomiting. The acidity of the stomach contents is almost as bad as battery acid! The repeated acid attack on the teeth can lead to dental decay which can then lead to fillings or even more extensive treatment needs.
  • Many moms-to-be will neglect their own dental visits during the pregnancy. This is often due to a fear that a routine dental cleaning will impact their pregnancy (it will not!). As a result, dental problems go undetected and end up causing major problems post-partum, sometimes requiring a tooth extraction and then a dental implant.

Pregnancy and Tooth Loss

With the reasons cited above, one can reasonably understand the conclusions from the NYU Study. But it doesn’t have to be that way!

There is no reason to delay a dental appointment during your pregnancy. We have treated hundreds of pregnant patients over the years and we will be happy to see you. And if there are areas of concern, we will discuss it with you and your obstetrician to assess whether treatment should be done before childbirth or after. We are always a phone call away if you have questions.