What Are the Risks of Medications on Your Oral Health?

Oral Health

While medication can help treat illness and improve health, we may not always consider the unintended effects it can have elsewhere in the body.

Did you know that some common prescriptions and over-the-counter drugs can negatively impact your dental health? As it turns out, the mouth is highly susceptible to systemic influences.

In this article, we’ll explore several risks medications pose to your teeth and discuss steps you can take to minimize harm.

1.    Tooth Decay

According to TorHoerman Law, a common medication used to treat opioid addiction called Suboxone consists of two active ingredients – buprenorphine and naloxone. It is available in both dissolvable strips placed under the tongue (known as sublingual films) as well as tablets.

The sublingual film version has proven to be quite effective and easy for patients to use. Buprenorphine helps reduce withdrawal symptoms and cravings by acting as a partial opioid agonist, while naloxone counters the effects of opioids by serving as an antagonist.

However, this medication has been found to significantly increase the risk of severe dental issues due to its acidic properties. In early 2022, the US Food and Drug Administration issued a warning regarding dental problems reported by those using buprenorphine to treat opioid addiction or manage pain.

In response, the manufacturer added a label on their medications cautioning about potential tooth decay.

Some patients have since come forward with lawsuits such as the Suboxone tooth decay lawsuit, claiming the company failed to properly disclose this side effect to both medical providers and consumers of the drug.  The victims claim that this has resulted in serious dental injuries from taking the medication as prescribed.

However, there are certain steps you can try to prevent tooth decay while you are on Suboxone. For optimal absorption and to reduce acid exposure, it’s best to place all Suboxone tablets or films under your tongue at once rather than splitting the dose. Make sure to keep them separated until fully dissolved.

Once dissolved, rinse your mouth with a generous sip of water, swishing it around to clear any residue and neutralize acid levels. Avoid brushing immediately afterward, as excess acid can weaken tooth enamel.

Wait at least an hour after taking Suboxone before brushing to minimize the risk of tooth decay. Keep your dentist informed about your Suboxone use to address any oral health concerns effectively.

Regular dental checkups and cleanings are essential, and if you notice any new tooth issues like cavities or sensitivity, contact your doctor promptly. By collaborating closely with both your physician and dentist, you can effectively monitor the impact of Suboxone on your oral health.

2.    Dry Mouth

Dry mouth, also known as xerostomia, can be caused by several common medications that decrease saliva production. When saliva levels are too low, the delicate tissues inside the mouth do not receive their usual moisture and may become irritated and inflamed.

This lack of protection raises the risk of infections developing, as well as tooth decay and gum disease. Over 400 prescription and over-the-counter drugs are recognized to potentially induce dry mouth as a side effect. Chemotherapy treatments can also leave patients feeling persistently parched.

Dry mouth can be a potential adverse reaction to various classes of medications. These include antihistamines, antidepressants, antipsychotics, and drugs for Parkinson’s and Alzheimer’s disease.

Additionally, inhaled lung medicines, certain blood pressure and heart medications, seizure drugs, isotretinoin for acne, and anti-anxiety tablets may also cause dry mouth.

While dry mouth can be an uncomfortable and inconvenient symptom, in many cases, the medical benefits of continuing the prescribed treatment outweigh the drawbacks.

Simple actions like drinking extra water throughout the day or chewing sugar-free gum may help alleviate the sensation of dryness temporarily.

Saliva substitutes that are sprayed directly into the mouth are also available and may provide relief for those struggling with medication-induced dry mouth. Maintaining good oral hygiene also aids in preventing related dental issues.

3.    Oral Thrush

Inhaled corticosteroids are useful for managing respiratory symptoms as they reduce airway inflammation and suppress the immune response. However, this can have the unintended effect of weakening immunity in the throat and mouth.

Normally, the mouth hosts a balance of various microbes like bacteria and yeasts. A weakened immune system may disrupt this equilibrium, allowing an overgrowth of the Candida fungus. This can lead to oral thrush, also known as oral candidiasis, which is a fungal infection of the mouth and throat.

Candida is commonly present in small amounts on mucous membranes throughout the body.

An overabundance of Candida can develop when the typical balance of microorganisms in the mouth is thrown off. Doctors may prescribe antifungal medications like clotrimazole, nystatin, or miconazole for mild cases. The patient would apply these topically inside the mouth daily for 7-14 days.

More severe infections are usually treated with fluconazole, which a doctor may administer as a pill or intravenously.

4.    Mucositis

Cancer treatments like chemotherapy and radiation can damage the rapidly dividing epithelial cells that line the gastrointestinal tract from the mouth to the anus. This leaves the underlying mucosal tissues vulnerable to injury and infection.

Mucosa, also called the mucous membrane, coats all passages open to the external environment in the respiratory and digestive systems. It secretes mucus to shield and lubricate these surfaces.

The oral mucosa lining the mouth is particularly sensitive. It is commonly impacted by chemotherapy and radiation, making the mouth a prevalent site of mucositis.

Mucositis occurs when cancer therapies erode the protective epithelial cell layer, exposing the raw mucosal lining. This induces several problems for patients, including pain, nutritional deficiencies from eating difficulties, and higher infection risk from open sores.

It seriously diminishes the quality of life and may necessitate lowered future chemotherapy doses. Individuals with oral mucositis and low white blood cell counts also face over four times the risk of septicemia. This is in comparison to those with just low white blood cell counts.

While mucositis itself cannot always be prevented, certain steps before radiation or chemotherapy can help minimize its effects and symptoms. It is advisable to consult an oncologist-recommended dentist in advance.

Proper denture fitting is important if they are worn. Any needed dental work, like extractions or denture adjustments, should be finished at least one month prior to therapy to allow full healing and avoid further mouth damage. Seeking early dental care can better protect oral health during cancer treatment.


1. What are the advantages and disadvantages of oral medications?

A: Oral medications are commonly chosen for their convenience, safety, and affordability, making them the preferred route of administration. However, they have limitations due to the typical movement of drugs through the digestive tract. Absorption of orally administered drugs may initiate in the mouth and stomach.

2. Which medications can cause mouth ulcers?

A: Mouth ulcers may be triggered by certain medications or treatments. These include non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, nicorandil used for angina, and beta-blockers prescribed for conditions such as high blood pressure and abnormal heart rhythms.

3. What are the risks of neglecting oral infections?

A: Ignoring oral infections can result in severe damage to teeth, gums, and jawbone and may even lead to life-threatening sepsis. Historically, tooth decay-related infections were a leading cause of death. Notably, an oral infection may not always manifest with pain.

In summary, while medications serve important purposes, it’s crucial we consider their total impacts on health and well-being.

By keeping open lines of communication between doctors and dentists, we can better monitor oral effects, take preventative measures, and address any issues promptly. Overall, health relies on treating both medical and dental concerns in an integrated manner.

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