Medications and Their Effects on Gum Disease

You may be unaware that certain medications can cause
changes to your gum tissue and promote gum disease. The
most common of these are antiseizure medications taken
for epilepsy. Dilantin, for example, is a drug that can create
gingival overgrowth, which has the appearance of
thickened tissue and loosened gums. Antidepressants such
as Paxil, Elavil, and Zoloft create gingival overgrowth and
swellings throughout the mouth. Studies have shown that
these changes take place on a cellular level and create a
more dense tissue. Another drug that causes overgrowth to
gum tissue is cyclosporine, used for immunosuppression in
people who have had transplants and people with multiple
sclerosis.
If you have overgrowth of tissue and are taking antiseizure
medication such as Dilantin, or are taking other
drugs that may be causing this condition, it is important that you have frequent oral cleanings and that you establish a
good oral hygiene regimen (see chapter 6). The thickened,
swollen tissues become a greater holding site for plaque and
bacteria.
Overgrowth of gum tissue and candidiasis can also be
caused by prolonged use of antibiotics, which reduce the
body’s defense mechanisms by stimulating immunosuppressants.
This condition is characterized by a thick white
mucous covering on the tongue. Patients with this condition
may have more plaque because they have pain from the condition
and therefore cannot brush their teeth easily.
It is important that you try to control the problem first.
Once this is accomplished, it will be easier to clean your
mouth and rid it of plaque. Use natural rinses such as Bioforce echinacea mouthwash and other herbal rinses
found in health food stores. There are rinses that can be prescribed
by your dentist or medical doctor to help you with
prolonged antibiotic therapy condition.
Lastly, many drugs can create xerostomia (dry mouth),
including:
• Anticholinergics, such as atropine, scopolamine, and
propantheline
• Antihypertensives, such as guanethidine (Ismelin) and
clonidine (Catapres)
• Antihistamines, such as diphenhydramine (Benadryl)
and chlorphenermine (Chlortrimeton)
• Antipsychotics, such as chlorpromazine (Thorazine),
promazine (Sparine), and thioridazine (Mellaril)
• Amphetamines and narcotics, such as meperidine
(Demerol) and morphine
• Anticonvulsants, such as lithium and carbamazepine
(Tegretol)
• Antidepressants and anti-anxiety agents, such as Paxil,
Elavil, and Zoloft
• Muscle relaxants, such as Norflex and Flexeril
• Diuretics, such as hydrochlorothiazide
Ask your physician if the drugs that you are taking can
be the cause of your gum problems. In many of my patients
who have thickened saliva and dry mouth, I find that these
conditions have been caused by medications. If I have been
seeing a patient frequently, and I have not noticed these
symptoms before, or they were not recorded on the medical
history, I ask the patient if he or she is taking any medica-tion. Dry mouth can cause gum irritation, and the loose gum
tissue becomes a greater holding site for bacteria and
infected gums.
Remedies: Seek professional advice. Also get over-thecounter
saliva replacements, such as Biotine or Arm and
Hammer baking soda chewing gum, which will moisturize
your mouth. Frequent professional cleanings also help. At
home, use frequent herbal mouth rinses to moisturize your
mouth.

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