“Many medications –including vitamins, minerals and herbal preparations-can have a negative effect on your oral health. Make sure that the dental office has your most recent medical history, including a list of all the medications (both over-the-counter and prescribed) that you use, as well as any chewable vitamins, herbs and similar products. Here are listed some common medication side effects.   Abnormal Bleeding Reduced blood clotting is a side effect of aspirins and anticoagulants, such as heparin or warfarin. These medications can be helpful in preventing stroke or heart disease, but can cause bleeding problems during oral surgery or treatment for periodontal diseases. Your dentist should be aware of any drugs you may be taking, especially when scheduling treatment that could involve bleeding.   Taste-Altering Medications Some medications can cause a bitter or metallic taste or affect the ability to taste. Among them are cardiovascular agents, central nervous system stimulants, nonsteriodal anti-inflammatory drugs, respiratory inhalants and smoking-cessation products such as nicotine skin patches.   Soft-Tissue Reactions Some medications have been linked to the development of oral sores, inflammation or discoloration of the soft tissues in the mouth. These medications include those prescribed for blood pressure control, immunosuppressive agents, oral contraceptives and some chemotherapeutic agents. If you take any of these and develop a soft-tissue reaction, your dentist may prescribe a special oral hygiene regimen to limit the discomfort caused by oral ulcers or inflammation.   Enlarged Gum Tissue Overgrown or enlarged gum tissue is known as “gingival overgrowth.” It is sometimes associated with anti-seizure medications such as phenytoin, immunosuppressant drugs such as those taken after organ transplantations and calcium channel blockers (including nifedipine, verapamil, diltiazem and amlodipine) that are taken by some heart patients. Meticulous attention to cleaning teeth and gums is important for patients with this condition.   Other Medications and Conditions Dry mouth is a potential side effect of numerous medications (prescribed an over-the-counter). Among them are antihistamines, decongestants, painkillers, high blood pressure medications, muscle relaxants, drugs for urinary incontinence, Parkinson’s disease medications, antidepressants and many others. Drying irritates the soft tissues in the mouth, which can make them inflamed and more susceptible to infection. Without the cleansing effects of saliva, tooth decay and other oral health problems become more common. Patients using oral inhalers for asthma often develop oral candidiasis, an oral fungal infection, and are encouraged to rinse their mouths with water after using the inhaler. Sugar is frequently part of liquid medications, cough drops, vitamins, antacid tablets and antifungal agents. People who receive long-term medication may be at greater risk of developing tooth decay when they are using sweetened medications. Consider selecting sugar-free alternatives (if possible) and taking medication with a meal (if the medication may be taken with food). Children taking syrup-based medications, such as cough medicines, are left with a sticky, sweet residue in their mouths. Children, too, should be encouraged to rinse their mouths with water after taking the medication. If you have undergone or are about to undergo cancer treatment, let your dentist know as soon as possible so that necessary dental work may be done before you begin taking medications that could affect your teeth, gums or jaw bone.   Prepared by the ADA Division of Communications, in cooperation with The Journal of the American Dental Association. Unlike other portions of JADA, this page may be clipped and copied as a handout for patients, without first obtaining reprint permission from the ADA Publishing Division. Any other use, copying or distribution, whether in printed or electronic form, is strictly prohibited without prior written consent of the ADA Publishing Division. “For the Dental Patient” provides general information on dental treatments (and dental careers) to dental patients. It is designed to prompt discussion between dentist and patient about treatment options and does not substitute for the dentist’s professional assessment based on the individual patient’s needs and desires.”