Side effects of antidepressants and sedatives on teeth and gums
by Dr. Nadia Abazarnia
The side effects of psychotropic drugs may cause dental problems.
You may be prescribed psychotropic drugs either for a mental illness or to manage severe anxiety associated with dental procedures. When these drugs are used they can cause problems such as dry mouth, bruxism, surgical bleeding, hyper salivation which need preventive dental care.
Dry mouth or Xerostomia
Most antidepressants can cause dry mouth. Dental management of a patient with dry mouth requires:
Grinding of the teeth or Bruxism
It is occasionally seen with antipsychotics, antidepressants. Bruxism involves grinding of the teeth, and leads to excessive dental attrition. The complications can be reduced by the use of an occlusal splint.
Surgical bleeding
Antidepressants and some anticonvulsant drugs, can impairs platelet aggregation which can potentiate surgical bleeding and this may occur in dental patients.
Drug-induced excess salivation Excess saliva may compromise dental materials during dental treatment and create a difficult working environment for the dentist and pose a risk of aspiration. Anticholinergic drugs can be used for patients suffering hyper salivation, before dental work, in addition to standard measures for maintaining a dry field.
Enlarging Gums Also known as Gingival Overgrowth, the Enlarging Gums are caused by the Immunosuppressant Drugs, Calcium Channel Blockers, and Anti-seizure Medications etc.
Preventing side effects of medications
It is not advisable to stop the medications for the fear of the side effects affecting the oral health adversely. What is required is that you let your dentist know that you are taking these medications. Also, you should inform your doctor or physician if you are experiencing any side effects.
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Even though they aren’t life threatening like bleeding or abscesses, dry sockets can be extremely painful. They are very common following surgery, and happen to be one of the most painful post extraction problems. Dry sockets are more common with removal of the lower teeth than they are with removal of upper teeth. No matter what type of extraction you have performed, a dry socket can occur with any type.
Although there is really no way to prevent a dry socket, you can help to reduce the risk by following your after surgery directions. Even though you may be following the directly precisely, you could still end up with a dry socket. They are known as a quirk of nature, and will make you feel like you are on your death bed – although you really aren’t. Those who are more at risk to dry sockets include those who smoke following extractions, and those who like to grind their teeth frequently.
A dry socket is a condition where the blood clot that forms after an extraction detaches itself from the socket walls. Sometimes, the clot will dissolve, leaving the bone exposed to food, the weather, and even saliva. Once the bone is exposed, it can become inflamed. The inflammation that occurs is very painful, often times being a deep pain that makes you feel as if you are dying.
If you leave it alone, the dry socket will heal. It will normally take around a month or so, although the pain won’t let up during the healing period. If you have a dry socket, you’ll find that antibiotics and even the strongest of prescription drug won’t cure it. An antibiotic will normally cure infections, although a dry socket isn’t considered to be an infection.
The best way to fight a dry socket is to go back to your dentist and have him pack the socket. Packing the socket is done without any anesthesia and can be quite painful. It doesn’t take long to complete, and it can provide relief from the pain. Once you have a dry socket, you won’t care about anything but stopping the pain. The pain can be so intense at times that you will be willing to do anything to stop the pain – even for a few minutes.
Once the socket has been packed, you will be relived from pain for a day or so. If you go back to your dentist, he will remove the old packing, wash the socket out, and place a new packing in. This way, you can get relief from the pain and help the socket heal. Keep in mind that it will take time to heal – and the best way to stop the pain is to do your best to avoid a dry socket at all costs.
Does one need Dental Insurance? This question is asked by us in parlance with any kind of insurance. Well, insurance is a tool that offsets financial losses due to accidents or incidents or unforeseen circumstances. With this in view, insurance is always advocated but if one is young and healthy and doesn’t need to visit a dentist more than twice a year, dental insurance will not be a requirement, since the premium for such insurance may be more than the annual tooth maintenance bill.
People with a turbulent dental history are advised to purchase dental insurance or join a discounted dental plan for the simple reason that dental bills can turn out to be very steep. Millions of Americans are undergoing root canal and cavity procedures despite the fluoride in drinking water. Dental health in the USA has not been of very high standard over the decades. Dental health depends upon a variety of factors including dental hygiene, stress, personal eating habits, nutrition etc.
The programs of dental coverage available are Indemnity Plans, Preferred Provider Plans, HMO Plans and Discount Plans
Dental Indemnity Insurance Plans
These are normal, traditional insurance coverage plans where you get a percentage of your dental bills covered for a monthly fee or premium. Normally a indemnity plan covers 100% of preventive services, 80% of restoration services and 50% of major treatment like orthodontics.
Dental Preferred Provider Plans
These plans cost an average of $40 per month and give you highly discounted rates of dental procedures within the specified network. A few benefits are available outside the network also. These plans are regulated by state insurance departments and fall in the insurance category.
HMO Dental Insurance
These insurance plans are also known as capitation plans. They operate like Health Maintenance Organizations (HMO). These are also regulated by state insurance department and cost between $20-$40 a month.
Dental Discount Plans
Discount dental plans are like clubs where you get the best deals when you show your membership card. These are again network based. They give best value to individual and family memberships. This membership is only purchasing a discounted access to a network dentist and is not considered insurance.
When dentists make dentures for a patient, there are many important measurements that must be made to provide the patient with cosmetically pleasing, comfortable and functional dentures. The measurements are made using wax blocks called occlusion rims that are made from the final impressions of the patient’s jaws. Using these wax blocks the dentist will determine where to put the teeth, the proper size of the teeth and how much space between the jaws that the teeth occupy. This last measurement is called vertical dimension, and it is critical to a successful outcome.
To visualize this measurement imagine that two dots are placed on your face. One dot on the bridge of your nose, and one dot on your chin, and then with your teeth in normal biting contact the space between these dots would be a measurement of the vertical dimension. Your teeth should only touch when you swallow, very momentary, and when you are chewing food.
The rest of the time your jaw muscles are at rest and there is a space of about 6 mm between your teeth known as the freeway space. This space is very important, because it allows chewing muscles and your jaw joints to live in a comfortable harmony that puts no excess stress on either the muscles or your jaw joints. This space is a critical part of the vertical dimension and if it is not reproduced by the position of the denture teeth, your dentures will not function well and will probably click when speaking. It will also produce fatigue of the chewing muscles, and could lead to pain in the jaw joints. By carving or adding to the wax blocks this space can be determined by observing the patient with their jaws relaxed, and by having the patient speak and making sure that the freeway space is adequate.
Once this is established the other measurements of where to place the teeth, and a correct position of the teeth when biting can be made. This information is preserved with a rigid bite relation registration, which is sent to the laboratory where the denture teeth will be placed in the wax blocks in the position indicated by the dentist’s measurements.
At the next appointment the wax setup dentures will be tried in the patient’s mouth and the teeth position, esthetics, correctness of the bite and very importantly the vertical dimension will be verified. Only when all of these requirements are met will the dentures be finished in high quality acrylic resin and delivered to the patient with the expectation of comfort, pleasing appearance, and proper function.
Dr. Slaven, DDS