Be Watchful for the Effects of Diuretics on Oral Health
Saliva is an important component in oral health by helping to prevent cavities, periodontal disease, and glossitis as well as provide other benefits. Xerostomia, or dry mouth, can therefore lead to poor oral health. Scientists used to think that xerostomia was a natural factor of aging, but it is now widely recognize that xerostomia has numerous modifiable causes. One in particular is the use of diuretics, which help to rid the body of sodium and water and are commonly prescribed in older adults to treat diseases such as hypertension, congestive heart failure, and liver diseases.
Previous studies have linked use of diuretics with xerostomia, however, no studies on diuretics had been conducted on all parameters of saliva--until recently. In a study recently published in Annals of Medical and Health Sciences Research, Bajana Prasanthi, department of oral medicine and radiology, Vishnu Dental College and Hospital, and colleagues evaluated the effects of diuretics on saliva composition and flow rate, the prevalence of caries and periodontal diseases, and overall oral health status,
Over the course of a year, Prasanthi studied 100 patients selected from the departments of general medicine, cardiology and nephrology in Narayana Medical College and Hospital, Nellore. The test group comprised 50 patients who were taking diuretic medications for hypertension, congestive heart failure, or chronic renal failure. The control group comprised 50 gender- and age-matched patients who were not taking diuretic medications.
Prasanthi compared stimulated and unstimulated saliva flow rates, pH, buffering capacity, protein content, and sodium, chlorine and potassium ion concentrations of the saliva between the two groups. Additionally, the oral health of both groups was measured using oral hygiene index simplified (OHI), Russell's periodontal index, plaque index, decayed, missing, filled teeth (DMFT) index, and oral mucosal examinations. The results showed that test group had significantly lower salivary flow rates (both stimulated and unstimulated), pH, buffering capacity, and sodium and chlorine ion concentrations compared with the control group. All test group members had xerostomia. Additionally, the test group’s results showed significant differences compared with the control group’s results in the Russell's periodontal index (P˂.001), plaque index (P˂.001), and DMFT index (P<.01), and OHI (P<.01). The test group had more cavities and periodontal disease, and 50% of the test group members had mucosal lesions compared with 6% of the control group (P<.001).
Prasanthi concluded that patients taking diuretic drugs are more likely to have xerostomia, dental caries, periodontal disease, and mucosal legions. Since discontinuing diuretic medication may not be feasible in some older patients, alleviating drug-induced xerostomia through other means may helpful. For example, patients with dry mouth should avoid sugary or acidic foods and use fluoride toothpaste and mouth rinses designed for dry mouth to reduce the risk of dental decay, according to the Mayo Clinic.
–Leanna Taylor
