The elderly man had tooth decay like the dentist had never seen before, a large black hole on the outside of one of his two front teeth. The man had heart medicine which he put under his upper lip because he had a bad experience when he put it under his tongue. The hole in his tooth was formed because of them.
Gum disease and tooth decay may be caused by the intake of common medications that Americans always take, say oral medicine experts. Patients suffer tooth decay and gum disease because their doctors either don’t tell them these are the side effects of the medication or the doctors themselves have no clue.
One piece of advice a dentist and pharmacologist gives to co oral specialists is that they should ask their patients about their medications. He urges dentists to make careful observations on each tablet and pill and think about their side effects.
Oral medicine specialists, who taught classes at this week’s ADA meeting on recognizing drug side effects, said the top problems include the following facts. Statistics show that about 20% of patients who take calcium channel blockers develop gum swelling. Inflammation creates openings in the gums where bacteria can get it and cause swelling and gum disease. These medicines include some of the nation’s biggest selling drugs.
Drugs for epilepsy and drugs for child hyperactivity may also cause similar swellings. Cyclosporin is a drug used to prevent organ rejection and this can cause massive gum overgrowth. It looks like gum inflammation caused by leukemia, he said.
A side effect of radiation treatment for cancer, dry mouth is a side effect of hundreds of drugs. Those who don’t have enough saliva may need topical fluoride treatment because they are prone to various dental problems. The problems are serious enough that the dentist will ask doctors to switch patients with swollen gums from calcium channel blockers to another heart medicine if possible.
If not, they need very strict plaque control and to see the dentist every two months, he said. Indeed, gum side effects could be prevented by a clean mouth, said another dentist, who showed a photograph of a Procardia patient whose teeth and gums were so damaged the patient needed surgery. Absence of plaque is the absence of any problem, he stated.
The only visible part of the front teeth of the Dilantin patient in the photo he showed was the tips because of swollen gums. He stated that a patient who is taking Dilantin is recommended to consult the dentist in 10 days so that the gum pockets where bacteria lurks could be treated. Dentists don’t just point to prescription drugs as a problem. Sugar is an ingredient found in lozenges and cough drops, as well as antacids.
There was always a repeated occurrence of cavities inside a woman’s mouth every time. She rarely ate sweets and always brushed her teeth, so dentists were a bit confused. Large amounts of antacid were consumed by the woman every day, it was later found out.
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