Why we ask about your medications
The mouth is not separate from the rest of the body. Before we perform a procedure or prescribe anything, we look at your medical history and your prescriptions. It can feel personal to share, but the most common cause of drug interactions is a doctor not having your full history. Tell us about all your conditions, medications, supplements, vitamins and allergies, and any bad reactions you have had.
How common medications affect your mouth
- Cancer treatment: chemotherapy can cause mouth sores, inflammation, color changes in the soft tissue and dry mouth.
- Mood and behavior medications: antidepressants, anti-anxiety drugs, stimulants, antipsychotics and mood stabilizers can dry the mouth and raise the risk of decay.
- Diabetes: high blood sugar can cause dry mouth, taste changes, slow healing, inflammation and bleeding. Once blood sugar is well controlled with medication, and with regular dental care, the risk of gum disease goes down.
- Heart medications: calcium channel blockers (such as verapamil, amlodipine and nifedipine) can enlarge the gum tissue, which can contribute to gum disease.
- Seizure medications: phenytoin (Dilantin) is well known for causing gum overgrowth.
- Thyroid medications: they can change saliva production, tongue size and gum tissue.
- Osteoporosis medications: bisphosphonates can, rarely, cause a serious jawbone condition called osteonecrosis.
- Blood thinners: warfarin or clopidogrel can make gums bleed, especially when you floss.
Many other drugs affect the mouth too, depending on the form and dose. These include antihistamines, decongestants, painkillers, blood pressure drugs, muscle relaxants, bladder medications and Parkinson's treatments.
Why dry mouth matters
Saliva keeps harmful bacteria in check, neutralizes acids, helps repair enamel and rinses away food. When a medication reduces it, decay, gum disease and tooth loss become more likely. Drinking water, chewing sugarless gum and using a saliva substitute can ease the dryness.
Keeping your mouth healthy while on medication
The American Dental Association suggests regular professional care, brushing twice a day with a manual, powered or ultrasonic brush, and flossing daily. If you are in cancer treatment, the American Society of Clinical Oncology adds:
- Brush gently twice a day, using a soft brush that is child-sized or softened in warm water.
- Avoid irritating foods and cut back on sugar.
- Get enough vitamin D and calcium to support teeth and bones.
How we adjust your treatment
Many treatments have alternatives for people with certain conditions or medications. When a medication affects a procedure, we may change the plan. If needed, we talk with your doctor about safer options or a short pause in a medication. We also look for medications as the cause when you have mouth symptoms, and we may suggest a saliva substitute. Read more about dental cleanings and exams.
Never stop a prescription on your own. Talk to your doctor and to us first.
Common questions
What can I do to protect my mouth while taking psychotropic medications?
Cut back on sugar and brush with fluoride toothpaste. These simple changes can offset part of the effect of the medication.
Which heart medications change gum tissue?
Most often calcium channel blockers, such as verapamil, amlodipine and nifedipine. If your gums change, we can talk with your physician about an alternative.
Does my dentist work with my doctor?
Yes. With your permission, we can contact your doctor to adjust a medication, suggest safer options or plan around a procedure.
Do I need antibiotics before dental work if I have a heart valve condition?
Possibly. After reviewing your history, and sometimes after talking with your doctor, we may prescribe an antibiotic beforehand to lower the risk of infective endocarditis.
Will I need antibiotics if I have a joint replacement?
Most likely not. Current American Dental Association guidelines recommend against preventive antibiotics for people with prosthetic joints.