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Opioids and Other Label Warnings You Never See


Still flashing my own teeth

When I was a kid, all my grandparents had dentures. Eventually my mother would need them too. However, my great-grandmother managed to keep her teeth. When she died, people remarked that she had all of her teeth, said with the same awe-filled tone that one might remark that she had climbed Mount Everest.

My mother stressed the importance of  good dental hygiene. Her goals for me were simple. She wanted me to attend college and have my own teeth. So far I’ve done both.

When I go to my dental appointments, the dentist asks about my medications. Honestly, I have always treated this part casually. It was not until a recent appointment that I learned how important a full health history is for the well-being of my teeth.

She asked me if there were any changes in my medications. I tossed out that I’ve been taking Norco for a herniated disc in my neck. I probably wouldn’t have mentioned it except for the fact that I was about to submit my neck to an hour in a dental chair.

She asked me how much I was taking, how often, and if my mouth was dry. I said I was only taking the medication sporadically, and hadn’t noticed any drying effects. To which she said, “If you need to increase your use of Norco and notice your mouth getting dry, let me know.”

Now I was curious, especially since I know quite a few people who use opioids on a regular basis. My dentist proceeded to enlighten me. I’ll share what I learned at the end of this blog, but first a paragraph of basic information.

Hundreds of drugs will cause dry mouth. These include pain meds, antihistamines, decongestants, antidepressants, high blood pressure meds, and so on. In the old days of using interferon to treat hepatitis C, dry mouth was a nearly universal side effect. To help, we’d suggest drinking lots of water, sucking on lozenges, chewing gum and using dental products formulated for dry mouth. These all helped, but may not have gone far enough.

My dentist told me that when the mouth is consistently dry, the body tries to compensate by changing its pH level. This response actually causes risk of tooth loss. Adding moisture doesn’t correct the problem; it only makes it feel better. To prevent tooth loss, people with dry mouth need to use a fluoride rinse. She suggested starting with an over-the-counter rinse, but if I were to be on a steady dose of opioids, I needed a prescription fluoride rinse.

Who knew? Well, now we do.

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