Episode 75: Medicines & Your Mouth

[Eon Engelbrecht – E-Radio-SA] (0:04 – 0:47)

Welcome to Save Your Money, Save Your Teeth and in today’s episode, we’re tackling a topic that touches almost everyone: the surprising effects that everyday medicines can have on your mouth. From high blood pressure tablets to antidepressants, many prescriptions bring along oral side effects that patients often aren’t warned about.

So today with the help of Dr Clifford Yudelman from OptiSmile, we will explore how to recognise these changes, why they matter and most importantly what you can do to protect your teeth and gums while still getting the medical benefits that you need. Dr Yudelman, welcome back.

[Dr Clifford Yudelman – OptiSmile] (0:47 – 1:01)

Thank you, thanks for having me back and I hope you’re keeping well during this flu season. A lot of people seem to be going down and yeah thank goodness for medicines and things that help us feel better.

[Eon Engelbrecht – E-Radio-SA] (1:01 – 1:15)

Yeah, very grateful for medicines, but now I want to actually focus on blood pressure tablets or antidepressants and ask you: how do these common medicines affect your mouth?

[Dr Clifford Yudelman – OptiSmile] (1:16 – 2:25)

Yeah, so you’d be surprised how many medicines including blood pressure tablets and antidepressants quietly affect your mouth. Blood pressure tablets, especially something called a calcium channel blocker. You can ask your doctor what type of blood pressure medicine you have, but calcium channel blockers can make your gums swell up and grow over your teeth which can make brushing really tricky.

I haven’t seen that in a while, but in Australia I saw quite a few patients on those and it did actually affect their gums. Antidepressants and antihistamines often dry your mouth out and then you suddenly have lost your natural rinse system – your saliva. We’ve had quite a few podcasts about dry mouth and saliva and people can go back and listen to those. But basically without saliva, the bacteria build up, cavities creep in, your gums get inflamed and it’s not pleasant. So while medicine is helping your body, your mouth sometimes pays the price.

[Eon Engelbrecht – E-Radio-SA] (2:25 – 2:33)

So we touched on the dry mouth before but for new listeners, what exactly is dry mouth and why does it cause so many problems?

[Dr Clifford Yudelman – OptiSmile] (2:33 – 3:28)

Yeah, I think it’s good to touch on it in this podcast as well. In previous podcasts we spoke about dry mouth mainly from dehydration and things like that, and we also touched on other medical things. But today the dry mouth we’re talking about is caused by medications. Saliva is your mouth’s best friend – it washes away food, neutralises acids and even has special proteins that fight bacteria.

When medicines slow down saliva production, you end up with a sticky dry feeling in your mouth. Patients often say it feels like they have cotton wool in their mouth. The danger is without saliva, acids from food and bacteria sit on your teeth much longer and that leads to decay and gum problems. So dry mouth isn’t just uncomfortable, it’s also risky.

[Eon Engelbrecht – E-Radio-SA] (3:28 – 3:34)

And Dr Yudelman, can medications increase the risk of cavities and gum disease?

[Dr Clifford Yudelman – OptiSmile] (3:35 – 4:03)

Yes, absolutely. Imagine a city with no rubbish collection – things pile up, smell bad, attract pests. This is what happens in your mouth when your saliva drops: plaque builds up much quicker, bacteria thrive, and before you know it you’ve got gum inflammation, bleeding, cavities popping up in places that were never a problem before. It’s just got a knock-on effect from one thing to another.

[Eon Engelbrecht – E-Radio-SA] (4:04 – 4:08)

And what about blood thinners? Do they really affect dental treatment?

[Dr Clifford Yudelman – OptiSmile] (4:09 – 5:11)

They do but not in the way some people may think. Blood thinners don’t actually damage your teeth or gums, but they make it harder for your blood to clot. So if you need an extraction or surgery or even a deep clean, there’s a higher risk of bleeding.

That’s why it’s important to tell your dentist, even if you’re on baby aspirin. Baby aspirin is a very strong blood thinner. Then things like warfarin and some of the newer anticoagulants – we don’t want any surprises in the dental team. The dentist should ask you if you’re going to have surgery, are you on blood thinners? But in case they don’t, make sure you tell them so they can plan properly.

They may tell you to stop. You shouldn’t stop unless the dentist or doctor has told you to, and they’ll tell you when depending on your surgery. So don’t just stop them because I said so – make sure you ask your dentist or your doctor.

[Eon Engelbrecht – E-Radio-SA] (5:11 – 5:18)

And what about osteoporosis drugs? Why would you say dentists worry about them?

[Dr Clifford Yudelman – OptiSmile] (5:18 – 5:56)

Yeah, so as you know, we did a whole podcast all about this and we’ll also be talking again about other aspects of menopause. But that’s a great question because drugs like Fosamax are brilliant at strengthening bones, but they interfere with bone healing in the jaw, especially after extractions. There’s a terrible condition called osteonecrosis where your bone actually dies instead of healing. That’s why we’re very cautious and always ask if you’re on these medications before planning any big dental work.

[Eon Engelbrecht – E-Radio-SA] (5:56 – 6:02)

Dr Yudelman, inhalers for asthma or COPD, can they also damage your teeth or gums?

[Dr Clifford Yudelman – OptiSmile] (6:02 – 6:39)

Oh, most definitely. Inhalers, especially steroid ones, can leave a residue in your mouth and throat. There’s something called a spacer – make sure you always use a spacer, it helps the medicine spread out when you breathe it in. But these things can dry your mouth and trigger a fungal infection called thrush.

Over time, teeth exposed to this type of environment can start decaying faster. Rinse your mouth, brush your teeth after using an inhaler. It’s a little habit that makes a big difference.

[Eon Engelbrecht – E-Radio-SA] (6:40 – 6:46)

And are there any cosmetic side effects like staining or gum overgrowth from medicines?

[Dr Clifford Yudelman – OptiSmile] (6:46 – 7:59)

Yes. Like we mentioned, calcium channel blockers for blood pressure can cause gum overgrowth and make your smile look uneven. Epilepsy drugs like Dilantin cause a similar condition – Dilantin hyperplasia – where gums grow over teeth. It can be lasered away to look better and easier to clean, but it comes back if you’re still on Dilantin.

Then things like iron tablets and certain antibiotics such as tetracyclines can stain your teeth and make them look dark. Some mouth rinses prescribed for gum infections, like Corsodyl with chlorhexidine, if used too long, can stain teeth badly. Patients get very upset when they aren’t told to stop after a week or two. The good news is the stains do clean off with a polish.

[Eon Engelbrecht – E-Radio-SA] (7:59 – 8:05)

And in your experience, what should patients tell their dentist about the medications they’re taking?

[Dr Clifford Yudelman – OptiSmile] (8:05 – 9:20)

You should tell us everything, not just what you think is important. Even herbal medicines. When I practised in California, Ginkgo biloba was very common. Patients’ gums would bleed heavily during dental work, but they’d insist they weren’t on medication – until I asked specifically about Ginkgo.

Just because it’s from a plant doesn’t mean it’s not a medicine. The same with supplements like St John’s Wort or ginseng – these affect bleeding and healing. So whatever you’re taking, please make sure to tell your dentist so treatment is safe and effective.

[Eon Engelbrecht – E-Radio-SA] (9:20 – 9:27)

And are there ways to manage dry mouth or other side effects without stopping the medicine, Dr Yudelman?

[Dr Clifford Yudelman – OptiSmile] (9:27 – 10:42)

Yes, often it’s about small changes. Sugar-free gum or lozenges with xylitol, gels and sprays – artificial saliva – can help. They feel odd but they do work. My late dad used them and found them helpful.

Staying hydrated makes a big difference. Cutting back on alcohol and caffeine also helps. You don’t need to stop the medicine – you adapt and support your mouth while you’re on it.

[Eon Engelbrecht – E-Radio-SA] (10:43 – 10:52)

Just one more question, Dr Yudelman: what’s your best advice for listeners taking multiple prescriptions to keep their mouth healthy?

[Dr Clifford Yudelman – OptiSmile] (10:52 – 11:30)

My golden rule is: keep your dentist in the loop. If you’re on more than one medicine, the chance of side effects goes up. Regular visits mean we can spot early changes before they turn into expensive problems.

Brush twice a day with fluoride toothpaste, floss, and use what your dentist recommends like Tooth Mousse to remineralise teeth. Don’t underestimate sipping water throughout the day – it’s simple, but it really helps.

[Eon Engelbrecht – E-Radio-SA] (11:30 – 12:08)

Sounds like a good idea. Medicines can save lives, but they can also quietly harm your smile if you don’t know what to watch out for. The good news is with the right knowledge and teamwork between you and your dentist, you can stay on your treatment and still protect your teeth.

Bring a full list of your medications to your dental visits. I’m sure Dr Yudelman will be very happy to see that. Dr Yudelman, thank you once again. That was another edition of Save Your Money, Save Your Teeth.

[Dr Clifford Yudelman – OptiSmile] (12:09 – 12:17)

Thank you and look forward to chatting next week, this time about menopause and how it affects your mouth.

[Eon Engelbrecht – E-Radio-SA] (12:17 – 12:46)

Looking forward to that. Thank you, Dr Yudelman, and thanks to our listeners for joining us.

Remember, always consult your dental professional for advice tailored to your health. Subscribe for more enlightening discussions and join us again next time as we continue to explore the fascinating intersection of dental health and financial savvy. Until then, keep smiling and taking great care of your teeth.

[Narrator] (13:08 – 13:52)

Discover the world of dental excellence with OptiSmile. Join us for a weekly podcast featuring Dr Clifford Yudelman, a seasoned expert with 40 years of dental experience across four continents. Gain unique insights and expert dental advice by visiting OptiSmile.co.za for articles that illuminate the path to optimal oral health. Book directly online at OptiSmile.co.za. OptiSmile – where global expertise meets local care.