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For Immediate Release

Contact: Richard T. Koenig
Phone: 202-547-7613
Fax: 202-546-1482

Are The Medications You Take Reflected In Your Smile?

When the doctor changed her blood pressure medication a few weeks before, she did not give it much thought. Suddenly as she was brushing her teeth, she noticed that her gums were swollen and seemed to be growing over her teeth. Alarmed, she went to see her dentist who confirmed that the calcium channel blocker medication she was taking for hypertension was causing the gum problem.

This is only one example of the hundreds of medications that Americans take every day, from over the counter throat lozenges for a sore throat to prescription drugs for serious medical conditions, which have a profound effect on their teeth and gums. Many doctors either do not know these oral side effects or fail to discuss them with their patients.

Some of the most commonly prescribed drugs as Procardia, Cardizem and Adalat have oral side effects. Recent studies indicate that up to 20% of patients, who take calcium channel blockers for high blood pressure and angina, suffer from gum enlargement. When the gums enlarge and create pockets around the teeth, bacteria have a direct pathway to the jaw bone. This can cause serious periodontal infection leading to premature tooth loss," says Dr. Sally Cram, a periodontist and member of the D.C. Dental Society. Similar swelling of the gums occur with the use of anti-epilepsy (such as Dilantin) or anti-rejection drugs used in organ transplant patients (such as Cyclosporin).

Another serious side effect associated with prescription medications is dry mouth and decreased salivary flow. Saliva is important because it has antibodies and enzymes which help control bacteria. People who do not have enough saliva are prone to cavities, excess plaque and fungal infections, and gingival inflammation. Some of the biggest culprits are on the ATop 20" list of the most frequently prescribed drugs in the past year. Diuretics used to treat high blood pressure, such as Lasix and Diuril, can also cause dry mouth and lead to oral problems.

But is it only the prescription medications that can have negative effects in the mouth? No," says Dr. Cram, Apatients also need to be aware of the side effects of certain over the counter preparations. People tend to think that if it=s not prescription, it can't hurt me. Antihistamines are notorious for causing decreased salivary flow." And those seemingly harmless cough drops, antacid tablets and chewable Vitamin C pills are loaded with sugar (to make them taste better), which can cause tooth decay. The acidity of some vitamins and nitroglycerin tablets can also lead to severe tooth erosion.

So what is a person to do? Frequent check-ups with the dentist and good oral hygiene habits are you first line of defense against possible complications which may be associated with your medications. If you keep the plaque and bacteria down, the gum enlargement and inflammation will be greatly reduced. Always keep your dentist informed as to the prescription and over the counter drugs you are currently taking. Sometimes your dentist may call the physician and recommend an alternative medication which does not have the oral complications associated with your current medications.

Not all drugs are bad for oral health. With new research regarding the effects of medications on oral health, researchers are finding that some drugs can have positive effects in the oral cavity. Many patients who take gold salts for treatment of their arthritis are found to have a lower incidence of periodontal (gum) disease. It appears that the metal may alter bacterial enzymes which can destroy gum and bone tissue. Researchers have also found that patients who have been treated for acne tend to have better periodontal health. It seems certain antibiotics, like the tetracyclines used in treating acne, actually kill bacteria and stabilize collagen, a building block for tissues and bone. And those anti-inflammatory drugs we all pop for minor aches and pains may also play a role in improving gum health.

If you would like more information on the side effects of medications on oral health or a dental referral, contact the D.C. Dental Society at (202) 547-7615.

For more information about oral health issues, visit www.dcdental.org and the American Dental Association Web site at www.ada.org.