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 beneficial. However my gums bleed each single time.”
I checked out her chart. Then I checked out her treatment listing.
And there it was: Atorvastatin. 40mg day by day.
“Carol,” I stated, “when did the bleeding begin?”
She thought for a second. “Possibly… six months after I began the ldl cholesterol treatment?”
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 12 months. Similar criticism. Bleeding gums. Good oral hygiene. Utterly confused about why it was occurring.
This article will not be about whether or not you want the treatment—that’s between you and your physician. That is about understanding the unintended 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 Medicines)
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 accountable for making Coenzyme Q10 (CoQ10)—a nutrient your physique wants for mobile power manufacturing.
Your gum tissue is extremely metabolically lively. It’s continuously therapeutic, combating micro organism, and regenerating. That takes a variety 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 outcome: 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 important enhancements in bleeding, pocket depths, and irritation.
This is the CoQ10 my spouse and I take every single day.
2. Antidepressants (SSRIs)
Medicines like Zoloft (sertraline), Prozac (fluoxetine), Lexapro (escitalopram), and Paxil (paroxetine) are lifesaving for hundreds of thousands of individuals coping with melancholy 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 facet 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: stop harmful blood clots.
However your gums? They bleed extra simply. It’s not as a result of they’re diseased (although they could be). It’s as a result of your blood doesn’t clot as shortly.
I’ve had sufferers on Coumadin whose gums bled for days after a deep cleansing. It’s scary, nevertheless it’s anticipated given the treatment.
4. Blood Strain Medicines (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 Medicines
When mixed with excessive blood sugar, sure diabetes medicines can create the right surroundings 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 Pissed off…
What number of docs warn their sufferers about these oral unintended effects once they write the prescription?
In 40+ years of follow, I can rely 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 may trigger dry mouth and bleeding gums.
Please don’t learn this as me blaming docs. They’re doing their finest 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 danger of coronary heart assault by practically 50%.
So in case your statin is depleting your CoQ10, inflicting gum illness, which will increase your cardiovascular danger… we’ve created a vicious cycle.
Your gums aren’t separate from the remainder of you. The irritation in your mouth impacts your complete cardiovascular system, your mind well being, your metabolic well being.
If you happen to’re on a statin:
✅ Complement with CoQ10 – 100-200mg day by day of ubiquinol (the lively type)
This straight addresses the nutrient depletion attributable to the treatment. Analysis reveals it could considerably enhance gum well being in statin customers.
➤ This is the CoQ10 I take day by day – ubiquinol type for max absorption
If you happen to’re on an SSRI:
✅ Tackle dry mouth instantly – That is the larger concern
- Sip water all through the day
- Use a xylitol-containing gum to stimulate saliva
- Think about a saliva substitute spray at evening
- Keep away from antibacterial or important oil mouthwashes (they make it worse)
✅ Be further mild when brushing – Your platelets aren’t functioning usually, so bleeding occurs extra simply
✅ Help total gum well being with vitamin
CoQ10 may nonetheless assist with total tissue therapeutic and power, nevertheless it gained’t reverse the platelet impact. That’s simply the truth of the treatment.
If you happen to’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 offer you correct aftercare directions
✅ Use mild stress when brushing – Electrical toothbrushes with stress sensors (or simply use your non. Dominant hand) are your good friend
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 may work along with your doctor. Ask if it could be a good suggestion to take the identical treatment however at a unique power, titrated down, and even altering producers of the treatment. Once more, please don’t do that by yourself—collaborate along with your physician. Everybody responds in another way to completely different medicines.
2. Help Your Oral Microbiome
• Floss day by day (I want PFAS-free floss)
• Use nano-hydroxyapatite toothpaste like Fygg (code ATD15)
• Keep away from mouthwash – even the “pure” varieties disrupt your oral microbiome
• Tongue scrape day by day
3. Add These Vitamins
• CoQ10 (particularly should you’re on a statin or over 40)
• Magnesium – helps wholesome gums and mobile power.
• Vitamin C – essential for gum tissue restore
• Vitamin D3/K2 – K2 helps direct minerals the place they should go
4. Repair Your Respiration
If you happen to’re a mouth breather (particularly at evening), no complement on the earth will absolutely defend your gums. Dry mouth = gum illness.
In case your dentist isn’t speaking to you about this sort of factor, it could be time for a brand new dentist! Discover one close to you through my Practical Dentist Listing or by AADSM.org.
5. Inform Your Dentist
Carry your treatment listing to each dental appointment. Your dentist must know what you’re taking to allow them to regulate your remedy plan accordingly.
If you happen to’re on any of those medicines and your physician by no means talked about the oral unintended effects, you’re not alone. It’s one of the crucial neglected connections in drugs. However now —and you are able to do one thing about it.
This is the reason I really 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 who’s on these medicines and scuffling with bleeding gums. This info may change the whole lot for them.
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