Pharm Steve.. Meds and Gum Disease Question

[Maggie]

I was at the dentist today having a wisdom tooth cut out when the assistant said, "you must take medications that cause gum problems". I didn't go into my medication regemine but am wondering now what it could be.

I'm on Fentanyl, Lortab, for pain. Others include blood pressure meds, synthroid, and lipitor. Do any of these cause gum disease of any type? Don't go to any trouble if you don't know off-hand, but I was hoping something would jump out at you.

Thanks for all your help. I am a masters prepared nurse but since retiring, am forgetting so much of this type information.
Maggie

[Pharmacist.steve]

I was at the dentist today having a wisdom tooth cut out when the assistant said, "you must take medications that cause gum problems". I didn't go into my medication regemine but am wondering now what it could be.

I'm on Fentanyl, Lortab, for pain. Others include blood pressure meds, synthroid, and lipitor. Do any of these cause gum disease of any type? Don't go to any trouble if you don't know off-hand, but I was hoping something would jump out at you.

Thanks for all your help. I am a masters prepared nurse but since retiring, am forgetting so much of this type information.
Maggie

The "dry mouth" from the opiates can cause all sorts of mouth/teeth problems

[Maggie]

Thanks.
As always, your help is greatly appreciated.
Maggie

[Pike]

Your dentist should be aware of the medications you are taking ... I am guessing he does but the assistant did not read your chart.

I cannot speak about teeth problems as I have good teeth ... on my mothers side of the family we have a few cosmetic problems but even in those who live more than 100 years have good teeth at death.

I lived in the desert for several years and picked up a water habit due to the heat ... I kept the habit after leaving the desert.

I like to sip water & freeze bottles of water and rarely leave home without a bottle of ice I refill with water at public fountains, the ice will last for hours ... it is cheaper than buying a Coke and much better for the body.

Perhaps you could prevent future problems if you got a water habit.

Just a thought and good wishes.

Pike.

[ErinENj]

Dry mouth is a killer. I never had it very badly, but one time I went to my dentist, he was shocked to see my mouth. I've always had one or two cavities a year, but nothing major. Then one day I was on the way to my spiney's office eating Burger King's hash browns. Suddenly I got a sharp pain in the back of my mouth and started chewing on something hard. My wisdom tooth had shattered because it was so rotten. My dentist did the whole thing: x-rays, exam, etc. and found that I had managed to get 10 cavities in a matter of months since my last visit. By the time he got them all fixed, I ended up with 4 root canals and caps. Since then, the number of them has gone down, but I always have something. But, it's better than it was. My dentist actually told me once that I have the mouth he'd expect to see on someone who suffers from bulimia or other eating disorder.

My dentist suggested a couple of things to help combat the dry mouth's effects: 1- Brush with an electic toothbrush (I have the Oral-B pulsar. It's cheap, doesn't need to be one of those fancy and expensive ones.)
2- Use toothpaste specially designed for strenthening enamel and helping with gum disease. I use the Crest stuff.
3- Use a mouthwash that is also specially designed to replenish and strenghten enamel. There are a whole bunch of different products. I use the Colgate stuff and it isn't too intense. I can;t use stuff like Listerene becasue is just way too strong for me and is intensly uncomfortable.
4- Do NOT use anything that has whitening!!! I was surprised by this, but my dentist was adament about it. Whitening can destroy your teeth and eats away at whatever it comes in contact with. It's a pain in the butt to try and find a toothpaste and mouthwash that don't have whitening in it, but it's a must.
5- Like Pike said, make sure you always have something to drink with you. I never leave the house without at least a bottle of water. At night, I even find that I have to keep a bottle of water next to my bed because my throat just gets so dry at times. So make sure you always have something to drink or even some gum or candy to suck on (but not too much or the candy will do damage to your teeth and gums.)
6- I see my dentist more often than most other people. Originally, I was going in once a year I think, but then we moved it to every 6 months. When I went in the next time after 6 months, I had a bunch of cavities and it seems like it was too long to wait, so now I see him every 3-4 months. It helps to make sure that he catches anything when it is small and easier to fix before it turns into something more major and more difficult on both him and on me.

I think that's about it for the tips my dentist gave me. Oh, I'm forgetting a god one. Ask your dentist for this flouride gel stuff that you apply with a toothbrush immediately before bed.

I hope that no matter what, things start to improve. These meds have so many un-seen or even nonsensical side effects to them that suddenly just pop up without any warning.

[Mark N]

I drink water constantly to fight dry mouth but still have been having dental problems. It can help but sometimes the meds counter our best efforts. I follow all the things Erin's dentist told her yet I have been losing teeth as the enamel wears away.

[Leeaelle]

Just for additional information, meds for osteoporosis such as Actonel, etc., can cause dental problems too. I had to have several teeth removed by an oral surgeon and he said that these meds can cause erosion of the JAW (bone!!!) after having dental surgery. He brought me an article from the American Dental Assoc. warning about it, and I was asked to sign a waiver. Luckily I hadn't been on the medication that long, as I understand it pertains to people who have been on it for many years, i.e. 10+ yrs or so, but I'm not positive about that.

Just thought I'd mention it for those who need dental work. Thanks. Hugs, Lee

[Maggie]

I don't have a problem with dry mouth so I don't have any idea why my gums are tender. The only thing they do is bleed a little when I brush. I'm unsure as to why the dental assistant thought they were bad. Anyway, I am going to start doing better oral care.

That's interesting about the Actonel, although I don't take it.

Maggie

[shotspine]

Hi Maggie....

I assume you know to use a SOFT bristle toothbrush and floss gently. Your gums should not bleed at all if they are healthy and you are not brushing/flossing too hard.

[jane2]

It's dry mouth and I take biotene (comes in mouthwash toothpaste etc.) and is good for dry mouth but I'm still getting all kinds of gum infections. I've literally had an infection in my mouth for year, that's gone into the bone.

If you are taking that and all in b/t form (actiq or fentora), I can tell you that really screwed up my mouth. Opiates and all these pills in general dry out your mouth. The worst is that night, maybe because I'm a mouth breather and my sinuses are bad.