Article published by the American Dental Association
Many medications—both prescription and over-the-counter formulas—can affect oral health.
A common medication side effect is xerostomia, which leaves your patients at greater risk for dental caries. Artificial saliva or sugar-free hard candy can be suggested as ways to keep the mouth moist. Oral soft tissues, likewise, can be affected by medications. For example, inhalers often used by people with respiratory problems can cause oral candidiasis. Rinsing after inhaler use may prevent this fungal infection.
Other commonly used medications that may have implications for dental treatment include anticoagulant and antiplatelet medications, and antiresorptive agents. Anticoagulant and antiplatelet medications, commonly referred to as "blood thinners," are taken to prevent blood clots. Because they can cause prolonged bleeding after some procedures, like prophylaxis, gum surgery or extractions, there has been discussion about having the patient discontinue the medication before treatment. However, research does not support altering the routine use of these medications for dental treatment.1,2 The prescribing physician should be consulted before the patient stops taking any medication (see the ADA.org Oral Health Topic on anticoagulant and antiplatelet medications for further information).
Antiresorptive agents, like bisphosphonates, used in the treatment of some cancers or osteoporosis also have been associated with rare, but serious, jaw problems most often after extractions.
Treatments, like those for cancer, can affect oral health. If possible, conduct an examination before the patient begins treatment to identify any dental concerns and, if necessary prescribe treatments to help maintain good oral health during cancer therapies. Consultation with the patient's physician also can be helpful in developing a cohesive treatment plan. The National Institute for Dental and Craniofacial Research offers information for dental professionals who are treating patients who have cancer.
These are only a few examples of how medications can affect oral health and dental treatment. In general, talking to a patient's physician will help develop an overall picture that can be useful in managing patient care. A complete, up-to-date health history that documents prescription and over-the-counter medications being taken as well as any chronic or recent acute illnesses also can be important when making treatment decisions.
1. Nematullah A, Alabousi A, Blanas N, Douketis JD, Sutherland SE. Dental surgery for patients on anticoagulant therapy with warfarin: a systematic review and meta-analysis. J Can Dent Assoc 2009;75(1):41-41i. Accessed Sept. 23, 2011.
2. Jeske AH, Suchko GD. Lack of a scientific basis for routine discontinuation of oral anticoagulation therapy before dental treatment. JADA 134(11):1492-7.