The quasi constant presence of sugars or food in the mouth, insufficient brushing and a decrease in the quantity or the quality of saliva are all factors that contribute to the development of dental caries.

Sometimes, drugs expose patients to the risk of dental caries, through various mechanisms: via a high sugar content, by causing dry mouth, by increasing acids in the mouth, or by damaging the tooth enamel.

Medicinal products high in sugar include syrups, pastilles, tablets to be sucked and homeopathy granules, especially if they are taken over a long period.

Dry mouth can be caused by a wide range of drugs: antimuscarinics, H1 antihistamines, antidepressants, neuroleptics, opioids, amphetamines, cytotoxic anticancer drugs, etc. Various cardiovascular drugs expose patients to dry mouth.

Several asthma treatments increase the risk of caries.

The tetracycline group of antibiotics expose patients to irreversible yellow discoloration of the teeth and an increased risk of caries through damage to the enamel. They should be avoided in children under the age of 8 and from the second trimester during pregnancy.

It is recommended to drink a glass of water and to brush the teeth after taking medication containing sugar, and to avoid taking these medicines immediately prior to going to bed.

In patients chronically exposed to drugs that carry the risk of caries, it is wise to offer regular dental check-ups, dietary and oral hygiene advice.

©Prescrire 1 February 2015

"Drugs that promote dental caries. Psychotropics, sugar-containing medicines, etc." Prescrire Int 2015; 24 (157): 41-44. (Pdf, subscribers only).