Do you know what your medication is doing to your smile?

Many pharmaceutical companies are taking their cases straight past doctors and directly to consumers via television commercials, print ads and even Internet marketing.

Can’t get along in a crowd? Feel anxious around other people? No problem. Call your doctor and ask him or her about Paxil. The commercial says you’ll get your life back, and then, at the end, quickly runs through a list of common side effects.

The same holds true for several other pharmaceutical companies and the medicines they advertise. Stuffed up and feeling miserable during allergy season (and who isn’t)? Ask your doctor about Clarinex. High cholesterol? Try a sensible diet and Lipitor, which in many cases have brought down cholesterol levels by as much as 45 percent, according to its manufacturers.

Not one of these companies, though, tells you the consequences your teeth and gums might suffer as a result of taking some medications.

“Paxil, for example, can cause what we call ‘glossitis’, which is a literally a shiny tongue,” says Dr. Steve Gustafson, of Gustafson and Morningstar D.D.S. “Prozac can do the same thing. It’s a warning sign of dryness that can lead to gum line decay.

“When salvia decreases, bacteria can increase. The bacteria that causes cavities like a dryer environment,” Dr. Steve adds.

Several blood pressure medications and antihistamines also can cause dryness. “The extent and degree vary with each medication,” Dr. Steve says, “but it’s really not a good situation in any case.

“In some of the more severe cases, I recommend patients pick up artificial saliva at a drug store.  I know that can sound a little drastic, but if you let it go too long, you can get what’s called ‘a wandering rash of the tongue where the patient may complain of a burning sensation’,” Dr. Steve says, holding up a book featuring a photograph of the problem and its outcome.

Besides all that, Dr. Steve says Prozac and Paxil are known for causing changes in the way people taste foods. “It can also come across as a loss of taste,” he says.

Other medicines that can have an affect on your teeth and/or gums include, but are not limited to:

• Tetracycline. “It causes tooth discoloration in children 8 years old and younger. Sometimes it can look like a ‘banding’ effect, grayish brown, across the teeth.”
• Amoxicillin. Several articles available on an Internet search pairing amoxicillin and dentistry suggest finding a better alternative to this perennial favorite of the penicillin family because it can act as an anti-coagulant. “It can also cause white or brown spots to become embedded in the tooth enamel,” Dr. Steve says. In general, Dr. Steve says too much of any antibiotic isn’t a good thing because your body gets used to it, and then it doesn’t work as well as it should when you really need it.
• Dilantin, a drug for epilepsy. “This causes what’s called hyperplastic tissue. What it means is that there’s an overgrowth of gum tissue,” he adds.

Dr. Steve recommends asking your physician how a prescribed medicine might affect your teeth or gums while inquiring about other side effects.

As far as what you can do that’s healthy for your teeth and gums, “the answer is easy, but most people don’t do it,” Dr. Steve says with a laugh. “What’s good for your whole system is good for your whole mouth.

“Eat lots of fruits and vegetables. Get your required daily intake of vitamins C and B12. Be meticulous about your oral hygiene and think about shorter intervals between checkups,” Dr. Steve says.