Patients who use antidepressant medications may be at increased risk for significant adverse dental effects

Patients who use antidepressant medication may be at increased risk for significant adverse dental effects, according to an article in the January issue of the Journal of the American Dental Association.

"Potential adverse effects and interactions with other medications have direct implications for dental treatment," concluded the researchers from a university school of dental medicine.

For example, patients who develop dry mouth (xerostomia) due to their medication may have an increased risk for serious tooth decay, gum disease, bad breath, oral yeast infections, and other health problems in the tissues of the mouth.

Other potential adverse effects of antidepressant medications include orthostatic hypertension and interaction with vasoconstrictive agents. The authors noted that other medications, if administered at the same time, could increase those adverse effects.

In the retrospective study, the authors reviewed randomly selected records of patients undergoing dental therapy. Of the 1,800 records, 21 percent (381) indicated treatment with various antidepressants. Almost 58 percent of people in the antidepressant group were receiving treatment with 2 or more medications that had potential for dry mouth. In addition, 67 percent of the people in the antidepressant group took an antidepressant or other medication with potential for orthostatic hypotension. Of the 381 subjects on antidepressant medication, women outnumbered men by a 2.3-to-1 ratio.

According to the authors, a preventive care program for dry mouth should include patient education on home hygiene practices, increased water intake, fluoride applications, use of therapeutic agents that stimulate salivation, and regularly scheduled dental visits. Dental precautions related to vasoconstrictors include conferring with a patient's physician and using a minimal quantity of vasoconstrictor with local anesthetic.


 

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