As we age, we tend to take more and more medications. Many of these medications have side effects that can have an impact on your oral health. In the past, we have discussed how certain bisphosphonate medications for osteoporosis can cause a condition called osteonecrosis of the jaw (an area of bone destruction of the upper or lower jaw bone). This can happen, especially to patients undergoing cancer treatments.  Let’s discuss other common problems caused by medications.

• Certain antidepressants, antihistamines, blood pressure and other medications can decrease saliva. This causes Xerostomia which is dry mouth. Saliva is important for preventing decay because it contains antimicrobials, substances that kills or inhibits the growth of microorganisms, as well as, minerals such as calcium and phosphorus. We need this to help keep our teeth strong. Without saliva we have a greater risk of periodontal disease and decay.  Delayed healing, fungal infections and ulcerations can also occur from dry mouth. Additionally, dry mouth leads to halitosis or bad breath.

• Aspirin and other blood thinners, such as Coumadin or Plavix lessen the ability for blood to clot. While they’re helpful in preventing heart attacks and stroke, they may cause your gums to bleed, even during your routine hygiene exam.

• Some acne medications, such as Acutane, may cause black or gray discoloration of your teeth.

• Respiratory inhalants and nicotine patches can affect the ability to taste. They may also cause a bitter or metallic taste.

• Oral Contraceptives and pregnancy may cause gingivitis, bleeding and inflamed gums.

• In addition to prescribed and over-the-counter drugs, vitamins, minerals, and herbal supplements can also cause oral health issues that range from dry mouth to inflamed gums to taste alterations and bone loss. And did you know some herbal supplements also increase bleeding after dental procedures?  Chamomile, Ginkoba, Dong Quai, fish oil, ginger, ginkgo, ginseng, St. John’s Wart and Vitamin E may increase bleeding, especially after an extraction.

• Some Cancer medications may decrease your ability to fight off certain dental problems that might otherwise never occur because they reduce your immune response.

When we ask for an update in your medications, please think about it. It is important that Dr. Berman and our hygienists know about the medications you are taking so that they can provide you with the very best dental care possible. Prescribed, over- the- counter, herbal or vitamin supplements are equally important for us to know. If you have had any recent illnesses, provide that information also. Your health is just as important to us as your smile. We want to help you maintain both!

Many of you may have seen a report published recently online concerning a possible relationship between bitewing dental x-rays and brain cancer. At Smiles 4 A Lifetime, we have always respected the ionizing radiation produced by dental x-rays and have followed the American Dental Association list of guidelines for radiation exposure for decades. Additionally, we have installed digital x-rays seven years ago which substantially decreases by almost two thirds, the amount of radiation exposure needed to produce quality x-rays.

Without dental x-rays we would not be able to treat the diseases of the mouth, namely periodontal disease and cavities which would put our patients at great risk for pain and suffering and tooth loss. Feel free to discuss with us at any time the guidelines for x-rays concerning children, adolescents and adults with varying degrees of dental diseases. Basically, we only x-ray when it benefits the patient. That could be two years for one individual and more or less frequently for another.

As far as the study goes and the reports that followed, it is greatly flawed in several areas:

1. There actually was No scientific study done! That’s right. People were simply asked to remember if they actually had bitewing x-rays many years prior! Then they compared two groups of people with and without meningioma to remember about their x-ray exposure. No documentation was ever produced. Well, we all watch CSI….If there’s no evidence, how does anyone know what was done decades ago? How can a scientific study be based on memory?!

2. The study claims to have found a link with bitewing x-rays (four posterior cavity detecting x-rays) but none with a full mouth series of x-rays (EIGHTEEN x-rays!!). If four x-rays show a link to meningioma, wouldn’t eighteen of them show an even greater link? No such evidence was found.

3. Most of the people asked had x-rays taken decades ago when much higher settings and slower x-ray film was used. Today, we don’t even use film! Patients seldom remember when they had x-rays and what type they were. At Smiles 4 A Lifetime we have been using digital x-rays at much lower settings to minimize patients exposure. No such technology existed for the patients in the study to benefit from.

The bottom line is that over exposing patients to ionizing radiation has never and will never be a standard anywhere in dentistry. The American Dental Association has made very clear standards and when they are followed patients, are quite safe. Remember, ionizing radiation is the same energy that is produced by the sun which you are exposed to all of the time. A dental lead apron, digital x-rays and better machines are the “SPF” of dental x-rays. Feel free to discuss this or any other concerns you have with anyone on our team.