Stress and Periodontal Disease: Questions and Answers with Dr. Varon

Yes. There are several classes of prescription medications and over-the-counter drugs that list dry mouth as a side effect. Decreased salivary flow will lead to increased plaque and calculus formation and an increase in the caries rate. Increased plaque and calculus heightens the chance of periodontal infection. The occurrence of dry mouth in any two patients on the same medication is highly variable, however.

In addition, there are some medications that will cause a gingival inflammation. The most notable are Dilantin and Phenobarbitol (used for seizure disorders) and calcium channel blockers (a class of blood pressure medication). My position is that there is an indirect effect between these medicines and gingival inflammation. It is not adequate to simply acknowledge the "root" cause of changes in the environment that leads to these problems. Other environmental factors play a role. For instance, effects are possibly due to soft drink consumption (see my blog on sodas).

4. In what ways do psychiatric conditions impact the outcome of periodontal and other types of treatment?

There is no firm evidence, only speculation, that cortisol levels associated with psychiatric disorders cause periodontal disease. However, there are more studies indicating that these disorders influence self-care activities.

5. What can individuals with mental health problems do to protect their teeth and gums?

More frequent visits to the dentist's office for examinations or dental prophylaxis might be necessary to curtail dental diseases. Alternative methods, such as use of a high-end electric toothbrush and electric floss, may help maintain oral health without the dentist. Through a process of trial and error and consultation of a dental team, an oral hygiene routine can be developed to maintain good oral health.

6. What can individuals with gum disease or other periodontal issues do to improve their course of treatment?

The best way for individuals with gum disease or other periodontal issues to improve their treatment course is to comply with the recommendations of their dental team. Taking medications as prescribed is also important to better mental status and improve self-care.