A affected person got here to see me a few years in the past—let’s name her Carol.
She was 58, took nice care of her enamel, and had been on a statin for her ldl cholesterol for the previous 5 years.
“Dr. B, I don’t perceive,” she stated, clearly annoyed. “I brush twice a day. I floss each evening. I even use that fancy electrical toothbrush you really helpful. However my gums bleed each single time.”
I checked out her chart. Then I checked out her remedy checklist.
And there it was: Atorvastatin. 40mg every day.
“Carol,” I stated, “when did the bleeding begin?”
She thought for a second. “Possibly… six months after I began the ldl cholesterol remedy?”
Bingo.
That very same week, I had seen a 32-year-old affected person—we’ll name him Jake—who’d been on Zoloft for anxiousness for the previous yr. Similar criticism. Bleeding gums. Good oral hygiene. Fully confused about why it was taking place.
This article is just not about whether or not you want the remedy—that’s between you and your physician. That is about understanding the uncomfortable side effects no one talks about, and what you are able to do to guard your oral well being whilst you’re on them.
Let me stroll you thru the most typical culprits:
1. Statins (Ldl cholesterol Drugs)
Medicine like Lipitor (atorvastatin), Crestor (rosuvastatin), and Zocor (simvastatin) are taken by over 40 million People.
Statins decrease ldl cholesterol by blocking an enzyme in your liver referred to as HMG-CoA reductase. Nice for coronary heart well being.
The issue? That very same pathway is chargeable for making Coenzyme Q10 (CoQ10)—a nutrient your physique wants for mobile power manufacturing.
Your gum tissue is extremely metabolically lively. It’s consistently therapeutic, combating micro organism, and regenerating. That takes a whole lot of power.
When your physique doesn’t have sufficient CoQ10, your gums can’t produce the power they should keep wholesome, struggle irritation, and heal correctly.
The end result: bleeding, irritation, and finally… periodontal illness.
Research have discovered that 60% of sufferers with gum illness present a CoQ10 deficiency of their gum tissue.
And when researchers gave CoQ10 to individuals with periodontal illness, they noticed vital enhancements in bleeding, pocket depths, and irritation.
This is the CoQ10 my spouse and I take each day.
2. Antidepressants (SSRIs)
Drugs like Zoloft (sertraline), Prozac (fluoxetine), Lexapro (escitalopram), and Paxil (paroxetine) are lifesaving for tens of millions of individuals coping with despair and anxiousness.
SSRIs have an effect on platelet operate—particularly, how your blood clots. They intrude with serotonin uptake in platelets, which might make you bleed extra simply.
Add to that one other widespread SSRI aspect impact—dry mouth—and also you’ve received an ideal storm for gum issues.
Much less saliva = extra micro organism = extra irritation = bleeding gums.
3. Blood Thinners
Aspirin, warfarin (Coumadin), Eliquis, Xarelto—these medicines do precisely what they’re designed to do: forestall harmful blood clots.
However your gums? They bleed extra simply. It’s not as a result of they’re diseased (although they may be). It’s as a result of your blood doesn’t clot as rapidly.
I’ve had sufferers on Coumadin whose gums bled for days after a deep cleansing. It’s scary, however it’s anticipated given the remedy.
4. Blood Strain Drugs (Calcium Channel Blockers)
Medicine like amlodipine (Norvasc) and nifedipine (Procardia) could cause gum overgrowth (referred to as “gingival hyperplasia”). Your gums actually begin rising over your enamel, trapping micro organism and inflicting irritation.
5. Diabetes Drugs
When mixed with excessive blood sugar, sure diabetes medicines can create the right atmosphere for gum illness. Excessive glucose in your saliva feeds unhealthy micro organism. Your immune system is already compromised by diabetes. And a few medicines could cause dry mouth.
It’s a triple risk.
The Half That Makes Me Annoyed…
What number of medical doctors warn their sufferers about these oral uncomfortable side effects once they write the prescription?
In 40+ years of follow, I can depend on one hand the variety of sufferers whose heart specialist advised them to complement with CoQ10 when beginning a statin.
Or whose psychiatrist talked about that their SSRI would possibly trigger dry mouth and bleeding gums.
Please don’t learn this as me blaming medical doctors. They’re doing their greatest in a damaged system. However the actuality is: they’re not skilled to consider how medicines have an effect on the mouth. Simply as we dentists aren’t skilled to consider how oral well being impacts the remainder of the physique!
That’s the place useful dentistry is available in.
Right here’s the tragic irony…
Individuals take statins to guard their coronary heart. However gum illness will increase your threat of coronary heart assault by almost 50%.
So in case your statin is depleting your CoQ10, inflicting gum illness, which will increase your cardiovascular threat… we’ve created a vicious cycle.
Your gums are usually not separate from the remainder of you. The irritation in your mouth impacts your complete cardiovascular system, your mind well being, your metabolic well being.
In the event you’re on a statin:
✅ Complement with CoQ10 – 100-200mg every day of ubiquinol (the lively type)
This immediately addresses the nutrient depletion brought on by the remedy. Analysis exhibits it could actually considerably enhance gum well being in statin customers.
➤ This is the CoQ10 I take every day – ubiquinol type for max absorption
In the event you’re on an SSRI:
✅ Tackle dry mouth instantly – That is the larger problem
- Sip water all through the day
- Use a xylitol-containing gum to stimulate saliva
- Take into account a saliva substitute spray at evening
- Keep away from antibacterial or important oil mouthwashes (they make it worse)
✅ Be additional light when brushing – Your platelets aren’t functioning usually, so bleeding occurs extra simply
✅ Assist general gum well being with vitamin
CoQ10 would possibly nonetheless assist with general tissue therapeutic and power, however it gained’t reverse the platelet impact. That’s simply the truth of the remedy.
In the event you’re on blood thinners:
✅ Count on extra bleeding – It doesn’t imply your gums are diseased
✅ Inform your dentist and hygienist – They should know to allow them to regulate remedy and provide you with correct aftercare directions
✅ Use light stress when brushing – Electrical toothbrushes with stress sensors (or simply use your non. Dominant hand) are your pal
For EVERYONE on these medicines…
1. Don’t Cease Your Medicine
Please hear me: I’m NOT telling you to cease your prescription. That’s a dialog for you and your physician.
However I AM telling you to help your mouth and inform your physician/dentist about your signs whilst you’re on it.
You’ll be able to work along with your doctor. Ask if it could be a good suggestion to take the identical remedy however at a special power, titrated down, and even altering producers of the remedy. Once more, please don’t do that by yourself—collaborate along with your physician. Everybody responds in a different way to completely different medicines.
2. Assist Your Oral Microbiome
• Floss every day (I want PFAS-free floss)
• Use nano-hydroxyapatite toothpaste like Fygg (code ATD15)
• Keep away from mouthwash – even the “pure” sorts disrupt your oral microbiome
• Tongue scrape every day
3. Add These Vitamins
• CoQ10 (particularly if you happen to’re on a statin or over 40)
• Magnesium – helps wholesome gums and mobile power.
• Vitamin C – vital for gum tissue restore
• Vitamin D3/K2 – K2 helps direct minerals the place they should go
4. Repair Your Respiration
In the event you’re a mouth breather (particularly at evening), no complement on this planet will absolutely defend your gums. Dry mouth = gum illness.
In case your dentist isn’t speaking to you about this sort of factor, it may be time for a brand new dentist! Discover one close to you by way of my Useful Dentist Listing or by means of AADSM.org.
5. Inform Your Dentist
Carry your remedy checklist to each dental appointment. Your dentist must know what you’re taking to allow them to regulate your remedy plan accordingly.
In the event you’re on any of those medicines and your physician by no means talked about the oral uncomfortable side effects, you’re not alone. It’s some of the neglected connections in medication. However now you already know—and you are able to do one thing about it.
Because of this I like useful dentistry. We don’t simply deal with signs. We ask why. We join the dots between your medicines, your vitamin, your sleep, your microbiome—and we handle the foundation trigger.
– Mark
P.S. Ahead this to anybody you already know who’s on these medicines and scuffling with bleeding gums. This info may change all the pieces for them.
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