3 ways to keep your teeth healthy while on anti-depression medications

Adriana Wood, RDH at Sbenati Dentistry

Depression is considered an epidemic in Canada according to over half of the Canadian population, from survey results obtained by the Canadian Mental Health Association (CMHA). Characteristics of depression include: persistent sadness, constant irritability, and the loss of interest in activities you once enjoyed.  Since depression is very treatable, there are several modalities one can seek in order to deal with this mood disorder.  Treatments range from doctor consultations, to counselling, to medical management using pharmacotherapy.  As with other medications, depression medications such as Selective Serotonin Reuptake Inhibitors (SSRIs) and Tricyclic Antidepressants (TCAs), are associated with Depression is associated with decreased salivary flow resulting in dental decay, advanced periodontal disease, and burning sensation in the mouth (also known as dysesthesia). 

There are many factors associated with developing depression.  Such as, death of a loved one, diagnosis of a terminal illness, loss of work, as well as neurological disorders like multiple sclerosis, Parkinson’s disease, stroke or head trauma.  More importantly, certain medications can cause side effects such as depression.

As someone who has lived with depression and anxiety, I have had to learn to manage it over the years.  I must say these symptoms are real, I have experienced all of these and still experience them on a day to day basis, such as feeling tired, and oversleeping.  Not to mention memory loss and difficulty focusing on tasks.

The use of use of alcohol and other drugs can also lead to or worsen depression. Aside from the above-mentioned factors, depression may also occur for no reason.  The symptoms of depression generally include depressed mood, persistent sadness, irritability, feeling of  helplessness and guilt, fatigue or decreased energy, sleep difficulties (undersleeping  or  oversleeping), anxiety, poor concentration, poor memory, weight changes, thoughts of suicide, and the loss of interest in socializing or activities you once enjoyed. 

Common Oral Side Effects

The use of multiple medications in combatting depression may lead to dry mouth, also known as xerostomia. Xerostomia provides a breeding ground for biofilm (ie. plaque on your teeth), especially when oral hygiene is poor.
Dry mouth may lead to the following:

Rampant caries

  • Craniofacial pain (neuralgia), Burning sensation of the oral mucosa, generally the tongue

Some TMJ pain.

  • Long-term use of some of the medications can put you at a higher risk for dental decay. Some of these medications can cause an increase in your cravings, especially to carbohydrates. These cravings, will cause you to snack more frequently, putting you at a higher risk for dental decay.
  • Long-term use of antidepressants has been shown to be a risk factor for development of diabetes mellitus, which is also a risk factor for periodontal disease.

3 effective ways to keep your teeth protected during treatment

  • Using mints with xylitol to help decrease dental decay

Xylitol acts on the bacteria (Streptococcus mutans) by preventing them from growing. Overtime, the use of xylitol changes the microbiome of the mouth, allowing for good bacteria to flourish, and decrease the amount of decay-causing bacteria.

  • Using PreviDent or Clinpro 5000 as your daily toothpaste

These toothpastes contain 5 times the amount of fluoride that your normal toothpaste contains. With fluoride, your teeth become biochemically stronger. The material of the enamel, hydroxyapatite, is replaced with the much stronger and acid resistant compound, fluorapatite.

  • Avoiding sugary drinks:

Soft drinks, energy drinks, sport drinks and juices should be avoided as they contain significant amounts of sugar, putting you at a higher risk for developing decay. If you must have these drinks, drink them through a straw so your teeth aren’t being constantly bathed in sugar all day long.

Reference
Can J Dent Hyg 2019;53(3): 172-177