HJAR Sep/Oct 2020

42 SEP / OCT 2020 I  HEALTHCARE JOURNAL OF ARKANSAS ORAL HEALTH DIALOGUE COLUMN ORAL HEALTH MEDICATIONS have a huge impact on oral health. The Centers for Disease Control and Prevention (CDC) reports in the years 2013–2016, the percent of U.S. adults taking at least one prescription drug in the past 30 days is 48.4 percent. Adults taking three or more prescription drugs in the past 30 days is 24 percent, and those taking five or more prescription drugs in the past 30 days is 12.6 percent 1 . Any drug taken can have side effects, and side effects occurring in the oral cavity are no exception. While some patients don’t exhibit any symptoms, others suffer a great deal. There are multiple classes of drugs which cause ad- verse effects in the oral cavity, and the most common will be discussed. There are over 1,800 drugs from 80 drug classes which can cause xerostomia, better known as dry mouth 2 . Not only is dry mouth uncomfortable, the mucosa, which is the in- traoral tissue lining, can become ulcerated and infected. The lack of saliva can cause digestive problems indirectly, as saliva is the natural moistener for food when chewing and swallowing. When there is decreased or a lack of saliva, this can present a myriad of health issues, such as indigestion or choking 3 . Xerostomia is a major concern for patients, as saliva is a natural protectant for the hard and soft tissues intraorally. Patients who sud- denly experience xerostomia can have an in- crease in caries (decay) on the coronal (tooth portion) and root surfaces of their dentition. Colonies of bacterial plaque form and attach to these areas due to lack of saliva, which causes decay. The dry gum tissue becomes uncomfortable, and oral hygiene is affected since it can be painful to properly brush and floss teeth. Psychotropic medications can have quite a few side effects intraorally in both direct and indirect pathways. These mood-related drugs affect the oral cavity negatively since these specific drugs may cause lethargy, fatigue, and memory and motor impairment 4 . This can alter a patient’s regular practice of oral hygiene, due to their inability to carry out the daily regimen of hygiene techniques. In pre- scribing medications, the healthcare provider must realize the consequences, and be able to diagnose this issue in order to supplement with a fluoride rinse, artificial saliva tablets, or individual instructions for varied brush- ing and flossing techniques, when possible. There are medications that alter the pH in the oral cavity. Antacid tablets, antifungal medications, numerous liquid cough sup- pressants, and chewable vitamins or dissolv- ing tablets can change the pH intraorally 4 . EFFECTS OF MEDICATION on Oral Health