Teeth and drug use

Many drugs, both prescription and illegal, can cause tooth damage. Estimates suggest that about 40 per cent of people take at least one type of medicine that could cause tooth damage.

Healthy teeth and gums depend on good oral hygiene, a low sugar diet and regular visits to the dentist. Tell your dentist about any drugs you are taking, including illegal drugs. Prevention is certainly better than cure, since dental restoration treatments can be expensive and time consuming.

Your child’s developing teeth
A child’s permanent teeth start to form in the jawbones soon after birth. These developing teeth are vulnerable to certain substances including:

• Tetracycline – this antibiotic can tint permanent teeth a yellowish or brownish colour.
• Fluoride – strengthens teeth and is commonly added to water supplies and toothpaste. However, excessive amounts of fluoride can cause white or discoloured spots to form on developing permanent teeth. This is called fluorosis. Young children who routinely swallow fluoridated toothpaste are at increased risk.

• Reduces the population of bacteria in the mouth
• Cancels out decay-causing mouth acids
• Contains substances crucial to the ongoing process of re-mineralisation, which is the rebuilding of tooth enamel (the hard surface layer that protects the tooth).

• Antihistamines – these can cause dry mouth.
• Aspirin – chewing aspirin can directly damage the tooth enamel. Always take aspirin strictly as directed. The tablets should be swallowed whole with water.
• Asthma medications – some asthma drugs are highly acidic and can dissolve tooth enamel if used regularly over a long period of time.
• Syrups – medicated syrups that contain sugar can increase the risk of tooth decay if teeth are not brushed after these syrups are taken.

• Cocaine – also called coke, blow or nose candy. Users sometimes rub cocaine over their gums. Cocaine mixed with saliva creates an extremely acidic solution. The acids erode tooth enamel and expose the underlying dentine to decay-causing bacteria. Cocaine also causes dry mouth, which further increases the risk of tooth decay.
• Crack cocaine – also called freebase or rock. Crack cocaine is usually smoked in a pipe. The smoke directly contacts the inside of the mouth and damages enamel, gums and nerves.
• Ecstasy – also called love drug, E and eckies. Side effects of the drug include bruxism (tooth grinding), jaw clenching and dry mouth.
• Heroin – also called H or smack. People who use heroin tend to crave sweet foods, which can increase the risk of tooth decay if dental hygiene is neglected.
• Methamphetamine – also called speed, ice or meth. This drug causes severe tooth decay in a very short time. Dental professionals have coined the term ‘meth mouth’ to describe the extensive damage typically caused by this drug. Methamphetamine is highly acidic and attacks tooth enamel. Other side effects include dry mouth, bruxism and jaw clenching.

• Antihistamines
• Antihypertensives
• Chemotherapy drugs
• Cocaine, when rubbed over the gums
• Crack cocaine, when smoked
• Immunosuppressive drugs
• Oral contraceptives.

• If a medicine is causing your dental health problems, the dentist may suggest that you talk to your doctor about adjusting the dose or method of delivery. In some cases, it may be possible to switch to another type of medicine that does not risk your dental health.
• If the doctor advises that changing your medication is not possible, talk to your dentist about professional and at-home treatments that can help to protect your teeth.
• Fluoride strengthens teeth and reduces the risk of decay. The dentist may apply topical fluoride preparations to the surface of your teeth. Fluoride tablets or mouthwashes may be recommended for use at home.
• Decayed teeth will need dental fillings and perhaps restorative work such as crowns.
• Badly decayed teeth may need to be removed (extracted). Partial dentures, dental implants or full dentures may be recommended.
• The dentist can carefully trim gum tissue affected by gingival hyperplasia.
• The dentist can recommend various treatments (such as veneers) that can improve the look of your mouth.

• Brush your baby’s teeth with plain water.
• Brush your young child’s teeth with low-fluoride toothpaste. Teach your child to spit rather than swallow the toothpaste.
• Avoid carbonated soft drinks, which are highly acidic and can erode tooth enamel. Drink fluoridated water instead.
• Cut back on sweet or sticky foods such as biscuits or lollies.
• Chew sugar-free gum to encourage a steady flow of saliva.
• Pay careful attention to your tooth brushing and flossing habits. Clean your teeth thoroughly at least twice a day.
• Visit your dentist regularly.
• Ask your doctor, dentist and pharmacist about the medicines you take and if they may affect your dental health.
• Don’t stop taking any prescribed medicine without your doctor’s advice, even if the medicine can potentially harm your teeth.
• If you have a drug dependence problem, consider talking to your doctor about entering a drug treatment program.
• Your doctor and dentist may offer further self-care suggestions. Follow these suggestions carefully.

• Your dentist
• Your doctor
• Pharmacist
• Dental Health Services Victoria Information Line Tel. (03) 9341 0428, 8am to 5pm, Monday to Friday, or (03) 9341 0345 after hours
• DirectLine Tel. 1800 136 385 – for 24-hour confidential drug and alcohol telephone counselling, information and referral

• Many drugs – prescription, herbal and illegal – can cause tooth damage
• Estimates suggest that about 40 per cent of people take at least one type of medicine that could cause tooth damage
• People who use illegal drugs should consider talking to their doctor about entering a drug treatment program.

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