How Your Medications Can Impact Your Dental Care

Why does your dentist need to know about the medication you take for high blood pressure?

It is important that your physician(s) and dentist have a current listing of ALL medications you take, including herbal supplements. For example…

Medications such as Heparin or Warfarin lower your risk for stroke and heart disease by helping to reduce your potential to develop blood clots . While these are important medications, your dentist should be made aware due to potential bleeding problems during oral surgery or some procedures involving gum tissues.

Dry mouth is a common side effect of a wide variety of medications, including those prescribed and over-the-counter. These include antihistamines, decongestants, painkillers, high blood pressure medications, anti-depressants, muscle relaxants, drugs for urinary incontinence and many others. Oral dryness causes the tissues in the mouth to become inflamed, which places you at greater risk for infection. Insufficient saliva flow ups your risk for tooth decay and gum disease.

For those who take medications that help to strengthen bones, these have been associated with a rare but serious condition called osteo-necrosis of the jaw, known as ‘death of the bone.’ These medications, prescribed to help prevent or treat osteoporosis, are Fosamax, Actonel, Atelvia, Didronel and Boniva. Certain versions are administered by injection, including Boniva IV, Reclast and Prolia.

Osteo-necrosis of the jaw commonly occurs after certain dental procedures such as extractions or implant placement. About 90% of those who have experienced osteo-necrosis are those who took the medication in repeated high doses due to cancer or other diseases. However, 10% who experienced osteo-necrosis were taking much lower doses, mostly intended to treat osteoporosis. Those who currently take these medications or have taken them within the past year should reveal this to their dentist.

Some medications can sores in the mouth, inflammation or discoloration of gum tissues. Oral sores or discolorations may arise from taking medications for blood pressure, oral contraceptives and chemotherapy agents. Because some spots and discolorations can be symptoms of oral cancer, keeping your dentist aware that you take these drugs helps he or she to monitor these areas closely and appropriately. When your dentist is aware of all your medications, you can be adequately monitored without being treated for problems that mimic symptoms of something else.

Because most supplements do not require a prescription, they may seem safe or not connected to your oral health. However, a number of these can actually affect your care more than you realize. It is important for your dentist to know if you take…
 • Ginkgo Biloba and Evening Primrose – Can reduce your ability to clot, possibly leading to excessive bleeding during and/or after a dental procedure.
 • St. John’s Wort – Often taken to reduce anxiety, this herb can interfere with the metabolism of other medications, including sedatives, antibiotics and anti-inflammatory drugs. When combined with St. John’s Wort, these drugs can be less effective. On the other hand, narcotics such as codeine, Vicodin and oxycodone can become more potent when taken with St. John’s Wort, leading to sleepiness, lethargy and dizziness.
• Valerian – Has mild sedative effects. If your dentist prescribes drugs for anxiety or painkillers containing codeine, the effects of both together are greatly accentuated. This can lead to severe sleepiness, lethargy and dizziness that can last into the next day.
• Calcium and Magnesium – Combining these supplements with certain antibiotics can interfere with the absorption of the antibiotics. This can compromise your ability to fight off infection.

Your oral health is an important part of your overall health as “the window to your body.” Keep your dentist up-to-date on all medications and supplements you take to avoid undue complications.