Medications and Their Effects on Gum Disease

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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

Gingival overgrowth.

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-the-counter 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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