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Medication Effects on Teeth and Mouth
Many medications have known adverse effects on the oral cavity. The following is a review of common oral medication side effects:

Gingival Hyperplasia
 
Common offenders: phenytoin, calcium channel blockers, cyclosporine.
 
Primarily affects the anterior gingiva.
 
Aesthetically undesirable and may interfere with tooth eruption, speech, and mastication.
 
Treatment: Stop the offending agent when possible beause regression often occurs. Surgical resection using laser, electrosurgery, or scalpel.

Oral Candidiasis
 
Increased risk in patients with diabetes, immunosuppression, and
Xerostomia: Abnormal dryness of the mouth due to insufficient saliva production.
xerostomia.
 
Common complication of inhaled steroid use, usually for treatment of asthma. Physicians should counsel patients to use a spacer and always rinse the mouth after inhaled steroid use.

Staining
Several common medications can result in dental staining.
 
1.
Tetracycline (eg, tetracycline, doxycycline) exposure during dental development causes
Enamel: Intensely hard calcareous substance that forms a thin layer partly covering the teeth; the hardest substance of the animal body; consists of minute prisms arranged at right angles to the surface and bound together by a cement substance.
enamel
Hypoplasia: A condition of arrested development in which an organ or part of an organ remains below the normal size or in an immature state.
hypoplasia and yellow, brown, or greyish discoloration that affects all teeth. For this reason, tetracyclines should not be administered to pregnant women or children younger than 8.
 
2.
Iron. Liquid drops can cause an extrinsic grey-black stain on several or all teeth, which can generally be prevented or minimized by good oral hygiene. This stain can be easily removed by a dental professional.
 
3.
Fluoride. Overdose can result in
Fluorosis: An abnormal condition (as mottled enamel of human teeth) caused by fluorine or its compounds.
fluorosis of the permanent enamel and preferentially affects the incisors and molars. (See Chapter 6: Fluoride.) Mild fluorosis has a white, lacy appearance. Moderate fluorosis results in brown discoloration, and pitting occurs in severe fluorosis.

Xerostomia

 
A common side effect of anticholinergics, antidepressants, diuretics, and antihypertensives.
 
Patients experiencing this side effect should be monitored and encouraged to maintain good oral hygiene and frequent dental visits.


 
 
Inhaled steroids increase the risk for oral candidiasis.
 
Staining from iron supplements is not permanent.
 
Tetracycline staining affects all teeth.
 
Fluorosis preferentially affects the incisors and molars.
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