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The Dentist, the Drugs, and the Damage to Your Teeth
The dentist was not expecting to see such a large black hole on the elderly man's front tooth. It turns out the man gagged on his heart medicine when he stuck the nitroglycerine tablets under his tongue where they're supposed to go so instead he stuck them under his top lip. The medicines were to blame for this hole in his tooth.
According to oral medicine experts, medicines such as vitamin C tablets and blood pressure pills may have serious bearing on dental problems of Americans. Either doctors have no clue to these dental side effects or they don't let their patients know, say the specialists.
Dentists should ask patients to tell them about what medicines they take and for what medical conditions, a dentist and pharmacologist said. As you look through each medicine, think about how they can affect the patient's dental health, he tells dentists.
The following information was presented by oral medicine specialists who taught classes at this week's ADA meeting. Up to 20 percent of patients taking calcium channel blockers for high blood pressure and heart disease suffer gum swelling. Inflammation opens gums so that they are susceptible to bacterial infection, thus developing swelling and gum disease. These medicines include some of the nation's biggest selling drugs.
This kind of swelling can also be seen as effects of anti epilepsy drugs and amphetamines. A drug used by organ transplant recipients, cyclosporin can cause massive gum swelling. Its appearance also can resemble the gum inflammation caused by leukemia, he warned.
Medicines by the hundreds cause a side effect found in radiation treatment known as dry mouth. Dental problems result from lack of saliva, and those who don't have enough may need topical fluoride treatment. If the dentist does not agree with the doctor's prescription of calcium channel blockers, he would ask the doctor to change it to another heart medicine which does not cause too much dental problems.
If this cannot be done, then plaque buildup must be constantly controlled and trips should be scheduled every two months. Another dentist said the gum side effects could be avoided provided the mouth is kept clean. According to him, the absence of plaque would mean that there's no problem.
Because of swollen gums, only the tips of the teeth of a Dilantin patient could be seen in the photograph he showed. If you have patients going on Dilantin, getting them to the dentist in 10 days can minimize that condition, by treating gum pockets where bacteria lurks, he advised. The problem isn't just prescription drugs. An active ingredient in over the counter lozenges, cough drops, and antacids is sugar.
For one woman, new cavities showing up almost every time was a problem. She said she brushed regularly and avoided sweets, leaving the dentists so perplexed. The receptionist found out later on that this woman was actually taking antacid in huge amounts every day.
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