Oral Side Effects of Some Medications

Many people have health conditions that require prescribed or over-the-counter medications. Some of these may have side effects that can affect oral health.

The following are common side effects of over-the-counter medications:

Taste changes - Sometimes medications can alter your sense of taste. You may experience a metallic or bitter taste in your mouth. This is common among people who take multiple drugs. Medications that can cause taste changes include antibiotics and those used to treat conditions such as:

• Allergies
• Asthma
• High blood pressure
• Cancer
• Diabetes
• Gout
• Heart disease

Gingival hyperplasia - This condition is an overgrowth of gum tissue around teeth. In advanced cases, the gums can completely cover the teeth. The overgrowth is a symptom of poor oral hygiene or a medication side effect. However, it can be controlled by improvements in a person's brushing and flossing habits. Common drugs that can cause this condition include:

• Immunosuppressants
• Anti-seizure medications
• Calcium channel blockers

Dry mouth - When drugs cause the saliva in your mouth to decrease, you may experience symptoms, such as a feeling of stickiness in your mouth, saliva that is thick and stringy, bad breath, a dry or sore throat or difficulties chewing and swallowing. The symptoms may range from mild to significant and can affect your overall health, ability to eat and quality of life.

Your saliva helps to prevent tooth decay and gum disease by washing away sugar and food particles and making the bacteria in the mouth less harmful. When a person has dry mouth, their risk of tooth decay and gum disease may increase because their saliva is not able to function effectively and neutralize the bacteria. Common medications that can cause dry mouth include:

• Pain medications, such as opioids
• Anti-depressants
• Allergy medications
• Diuretics
• Muscle relaxants

Hairy tongue - When the natural bacteria in your mouth is out of balance, your tongue may look "hairy." Poor oral hygiene, dehydration, tobacco use, head and neck radiation treatment and dry mouth may increase your risk for hairy tongue. Your chance of developing this condition is greater if you are taking:

• Antibiotics
• Drugs used for controlling acid reflux

Oral thrush - Anyone can get thrush. However, it is more common in babies and older adults with weakened immune systems. Oral thrush is a yeast infection that occurs in the mouth. It may result in the presence of white patches, soreness that causes difficulty eating or swallowing, cracking at the corners of the mouth, loss of taste or irritation and pain under dentures. Stress, illness, smoking, dentures or medications can trigger oral thrush. Medications that may cause the yeast to grow and increase include:

• Those used to treat asthma
• Antibiotics
• Birth control pills

Oral ulcers - Oral ulcers are painful sores inside the mouth. They generally go away within two weeks on their own. However, a person may have underlying health issues that cause them to return. They can be the result of conditions that cause auto-immune damage, nutritional disorders, infections, injuries and stress. Common medications known to have side effects that may result in oral ulcers include:

• Antibiotics
• Anti-seizure medications
• Immunosuppressant drugs
• Non-steroidal anti-inflammatory drugs used for pain relief

What about sugary medications?

Sugar is often found in medications, such as cough drops, antacids, antifungal agents and chewable vitamins. Too much sugar can lead to cavities. To reduce your risk:

• Take the medicine in tablet form
• Take the medicine at mealtime
• Brush your teeth with a fluoride toothpaste after taking the medicine

Managing the side effects

Not all side effects are avoidable and every person's body responds differently to medications, so you may need to think about how to manage these side-effects when taking a new medication. Here are some tips for reducing the oral side effects of medications:

• If a medicine alters your sense of taste, talk with your doctor. They may decide to change your medication or recommend other treatment options.
• Practice good oral hygiene to avoid gum overgrowth and swelling. You can increase your brushing frequency, improve your technique and/or use an electric toothbrush. Floss and clean between your teeth daily. Visit your dentist twice a year or as recommended for cleanings.
• To manage dry mouth, stay hydrated and sip water, avoid caffeine, use sugarless candy to promote saliva production and use a humidifier at night.
• To reduce your risk of developing hairy tongue, practice good oral hygiene, use a tongue scraper, quit smoking/vaping, reduce your use of alcohol and stay hydrated with clear liquids.
• If you observe thrush or sores in your mouth, talk with your doctor or dentist. They may suggest a medication to treat the condition.

All medicines, whether swallowed, inhaled or injected, come with a risk of side effects. Many are known to cause oral problems and affect dental health. Some side effects can lead to long-term health issues if overlooked. It is important to always tell your dentist the medications you are taking, including over-the-counter ones.

Note: The information in this article is not meant to replace the advice of your dentist or another licensed healthcare professional. Talk to your dentist for any specific dental advice.