How Medications Can Affect Your Teeth, Gums & Mouth After 60

Medications can improve health, relieve pain and prevent serious disease.

But they can also affect the mouth.

The most important rule is:

Do not stop or change a prescription medication on your own because of a dental side effect.

Instead, tell your dentist and the healthcare professional who prescribed the medicine.

In many cases, the oral side effect can be managed without giving up an important treatment.

Dry Mouth Is the Biggest Medication Issue

Medication use is one of the most common causes of dry mouth.

A wide range of medicines can contribute, but not every drug in a category affects every person in the same way.

Some antidepressants and antimuscarinic medicines used for conditions such as overactive bladder are well-recognized examples.

Other medicines may also contribute.

Rather than trying to memorize a long list, ask:

“Could any of my medications be contributing to my dry mouth?”

Why Medication-Related Dry Mouth Matters

Dry mouth is more than an uncomfortable feeling.

Reduced saliva can contribute to:

• increased cavities
• exposed-root decay
• difficulty chewing
• difficulty swallowing
• altered taste
• oral soreness

Saliva is part of your mouth’s natural protective system.

What to Do About Medication-Related Dry Mouth

Start with the prescriber, pharmacist and dentist.

Questions include:

• Is this medication known to cause dry mouth?
• Is there another medicine that might cause less dryness?
• Could changing the dose or timing be appropriate?
• Could my combination of medicines be contributing?
• Do I need additional fluoride?

Do not change the dose yourself.

For a detailed dry-mouth plan, see:

Medications & Dry Mouth: What to Ask and What Can Help

Gum Overgrowth From Certain Medications

Some medications can cause gingival enlargement or overgrowth.

Well-recognized examples include certain:

• calcium-channel blockers
• antiseizure medications such as phenytoin
• immunosuppressive medications such as cyclosporine

The effect is not equally common with every medicine or every patient.

Why Gum Overgrowth Matters

Excess gum tissue can make it harder to:

• brush along the gumline
• clean between teeth
• control plaque

That can contribute to inflammation.

Management may involve:

• improved plaque control
• professional dental care
• discussion with the prescriber about alternatives when appropriate
• periodontal treatment in more severe cases

Never stop a blood-pressure or antiseizure medicine simply because the gums have enlarged.

Medications Can Change Taste

Some medicines can contribute to:

• metallic taste
• bitter taste
• reduced taste
• other taste changes

But medicines are only one possible cause.

Taste changes can also result from:

• infections
• dental problems
• dry mouth
• head or nerve injury
• cancer treatment

Persistent changes deserve evaluation.

Blood Thinners and Dental Bleeding

Anticoagulants and antiplatelet medications can make bleeding last longer.

Examples include:

• warfarin
• apixaban
• rivaroxaban
• dabigatran
• edoxaban
• clopidogrel
• aspirin

This does not mean you should stop them before visiting a dentist.

For most patients undergoing common dental procedures, anticoagulant or antiplatelet therapy generally does not need to be altered.

Any change for a higher-risk situation should be coordinated with the prescribing clinician.

For more detail, see:

Taking Blood Thinners? What to Tell Your Dentist Before Dental Work

Bleeding Gums Should Not Automatically Be Blamed on Medication

Blood-thinning medication can make bleeding more noticeable.

But gums that repeatedly bleed may still have:

• gingivitis
• periodontitis
• plaque accumulation
• another local problem

Have persistent bleeding evaluated.

Do not simply stop the medication.

Osteoporosis Medications and the Jaw

Some medications used for osteoporosis or cancer-related bone disease are associated with a rare but important condition called medication-related osteonecrosis of the jaw, or MRONJ.

Drug groups associated with MRONJ include some:

• bisphosphonates
• denosumab
• other bone-modifying or oncology therapies

The risk depends heavily on why the medication is being used and its dose.

For people taking antiresorptive medication for ordinary osteoporosis, the risk is generally low.

Don’t Stop Osteoporosis Medication Before Dental Work on Your Own

There is no universal rule that everyone taking an osteoporosis drug should stop it before an extraction.

The decision can depend on:

• medication
• dose
• duration
• reason for treatment
• planned dental procedure
• other risk factors

Your dentist and prescribing clinician should coordinate when needed.

Bring a Complete Medication List

Include:

• prescriptions
• over-the-counter medications
• vitamins
• herbal products
• dietary supplements

Update the list when anything changes.

What About Herbal Supplements?

“Natural” does not mean irrelevant to dental treatment.

Supplements can sometimes:

• affect bleeding
• interact with medications
• affect anesthesia or sedation

Tell the dentist what you use even if you bought it without a prescription.