Daryl E. Malena DDS
  Periodontics
10838 Old Mill Road
Omaha, Nebraska 68154
402 330 4100

A number of prescription drugs, over the counter drugs and natural supplements can cause periodontal problems.  

For example, aspirin is often prescribed to patients at risk of a heart attack or stroke.  One of its effects is to thin blood in a way that helps prevent second heart attacks, but the thinning effect can cause inflamed gums to spontaneously bleed, especially overnight.  If this happens, it may only mean that your gingival inflammation is badly in need of treatment, but it could also mean that your blood is thinned beyond the range that is safe for you.  Never take aspirin on a regular basis without consulting your physician, and never undergo dental or medical treatment without telling your doctor about your aspirin intake. Certainly you should never take aspirin or related drugs at the same time that you are on blood thinners such as warfarin or Coumadin.  In addition, some herbal teas also cause significant thinning of the blood and can be a problem when used in addition to aspirin or other blood thinners. 

Dilantin, known generically as phenyltoin, has long been used to prevent seizures and is critically important some patients in that it allows them to live a very normal life.  This drug has a strange side effect of causing gums to grow--sometimes they grow enough to actually cover teeth.  In some cases this effect simply cannot be avoided and the periodontist has to remove the extra gum tissue when it becomes a problem.  Fortunately modern methods of managing this drug and the diseases it is used for are making this problem very rare.

Modern cardiac drugs are nearly miraculous in their ability to control heart problems, but some of them cause small areas of gum tissue to over grow.  Nefedipine is probably the most common drug that causes this problem, but a number of others are also responsible.  There is a variety of these drugs and physicians are always willing to consider trying a different one to minimize the problem, but in some cases the drug must be continued.  Fortunately we have learned to control these areas well enough to make it only a nuisance in most cases. Here is a link:  http://www.perio.org/consumer/nifedipine.htm

Tobacco, especially in its chew and spit forms, often causes dramatic destruction of gum tissue resulting in rapid recession (often called "stripping") of the gingiva, which requires gingival grafts in order to repair it.  If this is not bad enough, it also is a major cause of oral cancer which is notorious for its damaging effects and poor outcomes.  The advice here is simply DON'T DO IT!  There are few things that can be purchased for human consumption that endanger your life as much as this form of tobacco. 

Some of the drugs used for asthma contain corticosteriods. These sometimes cause local immunosupression leading to a surface yeast infection in the oral cavity.  The drugs are lifesavers and fortunately, the yeast problem is usually easy to solve. Oral yeast infections also come from any treatment or disease that causes immunosupression (such as organ transplant or HIV) and from long term antibiotic use. 

Age, some diseases (such as sjogren's syndrome), radiation treatment and some medications cause xerostomia, a lack of saliva.  Aside from being uncomfortable, this can lead to extensive tooth decay, mostly at the gum line where it is expensive and difficult to repair.  For this reason at the first sign of this problem most dentists ask their patients to begin applying fluoride to their on a daily basis. If you have a dry mouth you should discuss it with your dentist, hygienist or physician. There are saliva replacements available at the pharmacy. 

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