• 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.
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, healthy saliva and regular visits to the dentist. It is important that you tell your dentist about any drugs or medications 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 give permanent teeth a yellowish or brownish colour.
  • Fluoride – thisstrengthens 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.
Talk to your dentist for further information on medicines that can affect the development of your child’s permanent teeth.

Saliva protects your teeth

Many drugs, both legal and illegal, reduce the flow of saliva and cause a condition called ‘dry mouth’. Dry mouth significantly increases the risk of tooth decay. This is because saliva:
  • reduces the population of bacteria in the mouth
  • reduces decay-causing mouth acids
  • contains substances crucial to the ongoing process of re-mineralisation, which is the repair of tooth enamel (the hard surface layer that protects the tooth) that has been damaged by acids.

Effect of medications on teeth and gums

Some medications, including prescription drugs and over-the-counter preparations, can damage your teeth. Medications can cause gum problems such as inflammation, bleeding or ulceration. Diseased gums can lead to other dental problems including tooth loss.

Some of these medications include:
  • Antihistamines– can cause dry mouth, and an increased risk of gum problems.
  • Antihypertensives – can lead to an increased risk of gum problems.
  • Aspirin – chewing aspirin can directly damage the tooth enamel, as aspirin is acidic. Always take aspirin strictly as directed. The tablets should be swallowed whole with water, not placed beside a tooth.
  • Asthma medications – some asthma drugs are highly acidic and can dissolve tooth enamel if used regularly over a long period of time.
  • Chemotherapy drugs – can cause a dry mouth and lead to an increased risk of gum problems.
  • Immunosuppressive drugs – can lead to an increased risk of gum problems.
  • Oral contraceptives – can lead to an increased risk of gum problems.
  • Syrups – medicated syrups that contain sugar can increase the risk of tooth decay if teeth are not brushed after these syrups are taken.
Some medications can cause the gum tissue to thicken and grow over the teeth. This condition is called ‘gingival hyperplasia’. Medications linked to an increased risk of gingival hyperplasia include epilepsy medications, cyclosporin (organ transplant rejection drug), some blood pressure medications and calcium channel blockers.

Talk to your doctor, pharmacist or dentist about whether the medications you are taking could harm your teeth.

Alcohol and smoking can affect teeth and gums

Regular intake of alcohol can cause a dry mouth and tooth damage, as most alcohols are acidic. Smoking is associated with an increased rate of gum problems as well as an increased risk of cancers, including oral cancer.

Illegal drugs can affect teeth and gums

The regular use of illegal drugs can cause significant tooth damage. Drugs that carry a high risk to your oral health include:
  • cannabis also called marijuana, pot and weed. Can cause dry mouth and can lead to an increased risk of gum problems. The smoke can cause oral cancer
  • cocaine – also called coke, blow or nose candy. Users sometimes rub cocaine over their gums, causing ulceration of gums and the underlying bone. Cocaine mixed with saliva creates an extremely acidic solution that erodes tooth enamel and exposes the underlying dentine to decay-causing bacteria. Cocaine and crack cocaine cause dry mouth, which further increases the risk of tooth decay. Cocaine can cause tooth wear by tooth grinding (bruxism)
  • ecstasy – also called love drug, E and eckies. Side effects of the drug include 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. Heroin can also cause dry mouth and tooth grinding
  • 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.
Any drug dependence or drug use that causes the person to neglect their personal hygiene, diet and dental care can significantly increase the risk of dental (and many other) problems.

Treatment for tooth and gum problems

Professional treatment depends on the particular medication or drug and its effects on your teeth and gums, but may include:
  • 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, bridges, 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 and smile.

Prevention of tooth and gum problems

Suggestions include:
  • Brush your baby’s teeth gently with plain water.
  • Brush your young child’s teeth with low-fluoride children's 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.
  • Minimise your intake of alcohol.
  • Consider quitting smoking.
  • 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.

Drugs and dental surgery

If you are scheduled for dental surgery, tell your dentist about your alcohol or smoking intake, as well as the drugs or medications you are taking or have recently taken, including prescription medicines, over-the-counter drugs, herbal preparations and illegal drugs. Some drugs, such as aspirin and blood-thinning medications, can increase the risk of uncontrolled bleeding.

Where to get help

  • Dentist
  • Your doctor
  • Pharmacist
  • Community dental clinics Tel. 1300 360 054 to find your local clinic
  • The Royal Dental Hospital of Melbourne:
    • General enquiries or to make an appointment Tel. (03) 9341 1000 or 1800 833 039 (outside Melbourne metro) Monday to Friday, 8:30 am to 5 pm.
    • Dental emergencies Tel. 1300 360 054 Monday to Friday 8.30 am to 9.15 pm, weekends and public holidays 9 am to 9.15 pm
  • Australian Dental Association Tel. (03) 8825 4600
  • Dental Health Services Victoria Tel. (03) 9341 1000 (standard charges apply) or 1800 833 039 (country callers), 8.30 am to 5.00 pm, Monday to Friday
  • DirectLine Tel. 1800 888 236 – for 24-hour confidential drug and alcohol telephone counselling, information and referral

Things to remember

  • 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.

More information

Mouth and teeth

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This page has been produced in consultation with and approved by: Australian Dental Association Victorian Branch

Last updated: June 2014

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Content on this website is provided for education and information purposes only. Information about a therapy, service, product or treatment does not imply endorsement and is not intended to replace advice from your doctor or other registered health professional. Content has been prepared for Victorian residents and wider Australian audiences, and was accurate at the time of publication. Readers should note that, over time, currency and completeness of the information may change. All users are urged to always seek advice from a registered health care professional for diagnosis and answers to their medical questions.