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 pissed off. “I brush twice a day. I floss each night time. I even use that fancy electrical toothbrush you really useful. However my gums bleed each single time.”
I checked out her chart. Then I checked out her remedy listing.
And there it was: Atorvastatin. 40mg every day.
“Carol,” I stated, “when did the bleeding begin?”
She thought for a second. “Perhaps… 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 nervousness for the previous yr. Identical grievance. Bleeding gums. Excellent oral hygiene. Fully confused about why it was occurring.
This article just isn’t about whether or not you want the remedy—that’s between you and your physician. That is about understanding the unwanted effects no person 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 commonest culprits:
1. Statins (Ldl cholesterol Medicines)
Medication 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 vitality manufacturing.
Your gum tissue is extremely metabolically energetic. It’s consistently therapeutic, combating micro organism, and regenerating. That takes numerous vitality.
When your physique doesn’t have sufficient CoQ10, your gums can’t produce the vitality they should keep wholesome, combat irritation, and heal correctly.
The consequence: 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 folks 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 tens of millions of individuals coping with melancholy and nervousness.
SSRIs have an effect on platelet operate—particularly, how your blood clots. They intervene with serotonin uptake in platelets, which may make you bleed extra simply.
Add to that one other frequent SSRI facet impact—dry mouth—and also you’ve bought 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 drugs 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 is likely to 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 Stress Medicines (Calcium Channel Blockers)
Medication 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 drugs can create the right surroundings for gum illness. Excessive glucose in your saliva feeds dangerous micro organism. Your immune system is already compromised by diabetes. And a few drugs could cause dry mouth.
It’s a triple menace.
The Half That Makes Me Pissed off…
What number of docs warn their sufferers about these oral unwanted effects once they write the prescription?
In 40+ years of observe, 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 may trigger dry mouth and bleeding gums.
Please don’t learn this as me blaming docs. They’re doing their greatest in a damaged system. However the actuality is: they’re not skilled to consider how drugs 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 purposeful 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 almost 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 total cardiovascular system, your mind well being, your metabolic well being.
In case you’re on a statin:
✅ Complement with CoQ10 – 100-200mg every day of ubiquinol (the energetic kind)
This immediately addresses the nutrient depletion attributable to the remedy. Analysis reveals it may considerably enhance gum well being in statin customers.
➤ This is the CoQ10 I take every day – ubiquinol kind for max absorption
In case 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
- Contemplate a saliva substitute spray at night time
- Keep away from antibacterial or important oil mouthwashes (they make it worse)
✅ Be further light when brushing – Your platelets aren’t functioning usually, so bleeding occurs extra simply
✅ Assist general gum well being with diet
CoQ10 may nonetheless assist with general tissue therapeutic and vitality, however it received’t reverse the platelet impact. That’s simply the truth of the remedy.
In case 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 alter therapy and offer you correct aftercare directions
✅ Use light strain when brushing – Electrical toothbrushes with strain sensors (or simply use your non. Dominant hand) are your good friend
For EVERYONE on these drugs…
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 possibly can work along with your doctor. Ask if it will be a good suggestion to take the identical remedy however at a distinct 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 another way to totally different drugs.
2. Assist Your Oral Microbiome
• Floss every day (I desire 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 every day
3. Add These Vitamins
• CoQ10 (particularly should you’re on a statin or over 40)
• Magnesium – helps wholesome gums and mobile vitality.
• Vitamin C – crucial for gum tissue restore
• Vitamin D3/K2 – K2 helps direct minerals the place they should go
4. Repair Your Respiration
In case you’re a mouth breather (particularly at night time), no complement on the planet will totally defend your gums. Dry mouth = gum illness.
In case your dentist isn’t speaking to you about this sort of factor, it is likely to be time for a brand new dentist! Discover one close to you through my Useful Dentist Listing or by means of AADSM.org.
5. Inform Your Dentist
Convey your remedy listing to each dental appointment. Your dentist must know what you’re taking to allow them to alter your therapy plan accordingly.
In case you’re on any of those drugs and your physician by no means talked about the oral unwanted effects, you’re not alone. It’s one of the crucial ignored connections in medication. However now you realize—and you are able to do one thing about it.
Because of this I really like purposeful dentistry. We don’t simply deal with signs. We ask why. We join the dots between your drugs, your diet, your sleep, your microbiome—and we handle the basis trigger.
– Mark
P.S. Ahead this to anybody you realize who’s on these drugs and combating bleeding gums. This data may change all the things for them.
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