There’s a joke about the side effects listed on a bottle of sleeping pills … ‘May cause drowsiness.’ There’s another one about how nicotine is the only drug that kills you when you use it properly. Whichever way you look at it, (medicinal) drugs are a mine field. They’re designed for one function and end up causing something else entirely. It’s why you sometimes visit a doctor and end up with a bag full of pills. The first one cures your ailment.
The others treat the side effects of your curative dose. These effects include dry mouth and decreased libido – which sometimes manifests are erectile dysfunction. For our purposes, we’re focusing on the former, because it’s this oral dryness that enhances susceptibility to cavities. To fully understand the link, it’s important to comprehend how cavities work, especially because our dental knowledge base has shifted in the past few years.
We’ve always believed bacteria cause cavities, and that eating too much sugar breeds bacteria. In reality – as explained by Dr. Steven Lin – oral bacteria have always been there, and they have a positive function. They secrete acid that keeps our mouths sterile and free of toxins. So the problem isn’t eating sugar … it’s eating too much sugar. This excess sugar overfeeds bacteria. And instead of getting obese like humans do, these bacteria excrete more acid than necessary, and it’s that acid that erodes our teeth.
Proper meal planning
Similarly, when we snack between meals and don’t give our mouths a chance to rest, then we don’t give saliva space to work. When you’re not eating, the saliva in your mouth is washing away that extra acid, restoring your mouth’s pH to neutral, and preventing cavities in the process. Good oral hygiene therefore involves sticking to main meals, not nibbling in the interim, cutting down simple (processed) sugars, and eating food with bite.
This last one exercises your jaw, and the ‘bite’ scrapes off the bits of food stuck to your teeth, ensuring bacteria doesn’t snack on them at midnight. This is also why your night-time brush is more important than your morning brush. It cleanses your mouth of food particles so bacteria don’t feast while you sleep. At the same time, collagenous foods with ‘bite’ stimulate your mouth to produce more saliva, which rinses out unused acid.
Back to medications. Many cause dry mouth by lowering your body’s ability to produce saliva. Which means there’s nothing to neutralise bacterial excreta, which in turn increases incidences of cavities. As we get older, our dental caries increases, and if it goes untreated, our teeth can start to fall out. We’ve always assumed this was a consequence of advancing age, poor oral hygiene, and lack of access to dental treatments, but there’s another factor at play. Age comes with tons of medication for one thing or another.
Medicines that moisten
Many of these medicines dry out your mouth, and since you’re likely taking five or six different prescriptions, the effect is magnified. At the other end of the spectrum, dental procedures can extend into generalised infection, which is why dentists prescribe anti-biotics before performing certain procedures. A lot of these medications – whether they’re fighting viruses, soothing arthritis, or relieving menopausal cramps – are essential. So you can’t just stop taking them, even if it’s for the sake of your teeth.
Instead, you should talk to your doctor about the side effects. If they can prescribe something kinder on your mouth but just as potent on your germs, that would be ideal. You should also tell your dentist if you’re currently taking any medication. You may feel your foot cream has no business in your root canal, but it’s best to let your dentist decide. Meanwhile, you can use other methods to increase your saliva supply and lubricate your dry mouth.
Caveats to cavities
Try chewing sugar-free gum or sucking on lozenges. They stimulate your salivary glands without tempting your bacteria to snack. You can also buy mouthwashes and sprays specifically designed to keep your mouth moisturised. They’re available over-the-counter, but you should still talk to your dentist for recommendations. Drink plenty of water, ideally two litres a day, at room temperature. Develop a habit of sipping your liquids throughout the day instead of downing all two litres at one go – it’ll just make you want to pee.
Fluoride has been proven to deter cavities, so infuse some into your drinking water and don’t boil it – otherwise the fluoride will evaporate. Your dentist can apply fluoride gels on your teeth, or prescribe fluoride tablets. On the occasions when you do have dry mouth, make a conscious effort to avoid foods that aggravate the dryness. These include coffee, fizzy drinks, citric juices, acidic foods, and fizzy drinks. You can also use humidifiers as needed.