Adverse Effects of Medication Use

Common Oral Side Effects of Medication Use

Complications of medication use can negatively impact oral comfort, function, and quality of life. How much do you know about the oral health risks of your patients’ drug regimens? 

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Xerostomia

Drug-induced xerostomia or dry mouth is the most frequently reported oral side effect among older adults, who may present with multiple comorbidities and depression. A recent review suggests the incidence of xerostomia increases with the number and dose of medications taken.

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Aphthous Ulcers

Several drug classes have been shown to cause aphthous ulcers. Although it may not be possible to switch the offending drug to another from a different medication class, if frequent ulceration affects the patient’s oral health-related quality of life, the prescribing physician should be contacted to determine feasibility of an alternate therapy. Topical over-the-counter and prescription anesthetics may help improve comfort.

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Gingival Hyperplasia

Gingival hyperplasia may be observed in patients taking anticonvulsants, calcium channel blockers, and immunosuppressants used to prevent organ transplant rejection. While it is difficult for patients to perform adequate oral hygiene with hyperplastic tissues, effective self-care may reduce the extent and severity of the lesion.

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Dysgeusia and Dysomia

More than 250 drugs have been associated with altering taste (dysgeusia) and smell (dysosmia). Older adults frequently complain that food tastes bland or they cannot taste certain foods, resulting in behaviors such as adding salt, over-seasoning foods, or simply not eating regularly. 

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Lichenoid Reaction

Lichenoid reaction is a delayed hypersensitivity reaction to a drug. Clinically, this condition is often confused with lichen planus, an autoimmune disease. There is a lack of consensus about diagnostic criteria because, with some cases, the condition may not resolve after the drug has been discontinued. Clinicians should assess a “new” presentation of lichen planus and correlate onset with the timing of the introduction of a medication since the last dental visit. 

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Radiation Therapy and Chemotherapy

Radiation therapy and chemotherapy used for cancer treatment can cause oral mucositis, which can occur directly as a burn from radiation and from exposure to the toxic drugs used during chemotherapy that are secreted into the oral cavity via saliva. Drugs used for chemotherapy cause systemic immunosuppression, which reduces salivary immunoglobulins and increases risk for oral infections. Mucositis causes significant pain and alters the patient’s ability to eat, swallow, and speak. 

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