Coumadin & Teeth

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rwsp768

Well-known member
Joined
Sep 15, 2005
Messages
65
Location
Olympia, Washington
Anyone else having problems with their teeth since you went on coumadin? My dentist told me that it causes a condition called dry mouth and since I have been on it they can't keep up with the cavities. Now we are down to pulling them and I am headed for false teeth. All the cavities are taking place either at the gum line or under it.
 
I'm in the process of getting dentures now, but it's not because of Coumadin. My teeth have been bad since birth. I can't say that I have heard of any such thing, so it'll be interesting to see if others have.
 
I'm fairly certain your dentist is propagating myth with imaginary diagnosis's for phenomena that he can't explain. Here is all of the adverse reactions and I don't see dry mouth anywhere.

ADVERSE REACTIONS
Potential adverse reactions to COUMADIN may include:
• Fatal or nonfatal hemorrhage from any tissue or organ. This is a consequence of the anticoagulant effect. The
signs, symptoms, and severity will vary according to the location and degree or extent of the bleeding.
Hemorrhagic complications may present as paralysis; paresthesia; headache, chest, abdomen, joint, muscle or
other pain; dizziness; shortness of breath, difficult breathing or swallowing; unexplained swelling; weakness;
hypotension; or unexplained shock. Therefore, the possibility of hemorrhage should be considered in evaluating
the condition of any anticoagulated patient with complaints which do not indicate an obvious diagnosis. Bleeding
during anticoagulant therapy does not always correlate with PT/INR. (See OVERDOSAGE: Treatment.)
• Bleeding which occurs when the PT/INR is within the therapeutic range warrants diagnostic investigation since
it may unmask a previously unsuspected lesion, e.g., tumor, ulcer, etc.
• Necrosis of skin and other tissues. (See WARNINGS.)
• Adverse reactions reported infrequently include: hypersensitivity/allergic reactions, including anaphylactic reactions,
systemic cholesterol microembolization, purple toes syndrome, hepatitis, cholestatic hepatic injury, jaundice,
elevated liver enzymes, hypotension, vasculitis, edema, anemia, pallor, fever, rash, dermatitis, including bullous
eruptions, urticaria, angina syndrome, chest pain, abdominal pain including cramping, flatulence/bloating, fatigue,
lethargy, malaise, asthenia, nausea, vomiting, diarrhea, pain, headache, dizziness, loss of consciousness, syncope,
coma, taste perversion, pruritus, alopecia, cold intolerance, and paresthesia including feeling cold and chills.
Rare events of tracheal or tracheobronchial calcification have been reported in association with long-term warfarin
therapy. The clinical significance of this event is unknown.
Priapism has been associated with anticoagulant administration; however, a causal relationship has not been established.
 
I haven't had any issues with losing teeth since I've been on Coumadin. I have been on Coumadin for 7 1/2 years and all of my dental check ups are good. I always ask how my gums are doing, and the dentist tells me they are fine.
 
Coumadin/Warfarin does NOT cause dry mouth, however many, many medications do. Dry mouth is the death of teeth. Saliva is the 1st line of defense against cavities. We have so many elderly in our office with rampant cavities because their medications cause dry mouth, and to combat that, they suck on hard candy, mints or cough drops.

I would suggest that you look at your entire list of medications, read the informational sheets that come with them from the pharmacy, so you know which meds might be causing this. Even so, you'll probably not be able to stop the medications.

Try to find sugarless gum and candies that contain Xylitol. Xylitol is a sugar alcohol made from beech bark, birch bark, corn cobs and other food items. It must be counted in a diabetics diet. If you eat too much it can cause intestinal upset like mannitol and sorbitol. But your body does adjust. The bacteria that cause cavities eat the xylitol and die instead of creating acid that eats at the teeth. It is a great defense.

Hope this helps.
 
Years ago I had dental problems that were due to poor dental hygiene on my part. For the past twenty+ years I have seen my dentist on a regular basis and have had few problems with my teeth. I've never had a dentist mention a condition called "dry mouth". I've been on coumadin/warfarin 41 years. Maybe our resident expert, Allodwick, can shed some light on this ?
 
I do know of someone who has "dry mouth" but in him it is caused by a salivary gland issue.

You're right Bina, salivary issues are a cause. Anyone who has had radiation treatment to the neck probably has salivary and dry mouth issues as well as those who are on bladder control medications or any kind of stimulant.

This is from the Mayo Clinic: http://www.mayoclinic.com/health/dry-mouth/HA00034/DSECTION=causes

"Hundreds of medications, including some over-the-counter drugs, produce dry mouth as a side effect. Among the more likely types to cause problems are some of the drugs used to treat depression and anxiety, antihistamines, high blood pressure medications, anti-diarrheals, muscle relaxants, drugs for urinary incontinence, and Parkinson's disease medications."
 
Anyone else having problems with their teeth since you went on coumadin? My dentist told me that it causes a condition called dry mouth and since I have been on it they can't keep up with the cavities. Now we are down to pulling them and I am headed for false teeth. All the cavities are taking place either at the gum line or under it.

Dry mouth is certainly a contributor to tooth decay,
BUT, if I were your Dentist I would want to know if you:
Brush and Floss Every Day (better yet, after every meal)
Rinse with Water,
Drink Sugary Drinks (Sodas, Coffee+Sugar, Tea+Sugar, Fruit Juices, etc.)
Rinse with Water,
Snack on Candy or Carbohydrates
 
There are a variety of medications that cause dry mouth, and some, like antihistamines, are available over-the-counter. There are also some medical conditions outside of salivary gland problems(like stones, etc) that cause it, like Sjogren's Syndrome, which is an autoimmune phenomenon. It is also frequently associated with rheumatoid arthritis, lupus, Crohn's disease, diabetes, and even some thyroid problems. Sometimes it is the first symptom of one of these problems, so if you are having a lot of joint pain, etc, ask your doc to test you. If you are taking diuretics, or have to limit your fluid intake, it can be extremely hard to treat. There are a couple of medications-Salagen and Evozac-that can help stimulate saliva production. Sugar-free sour candies can stimulate saliva production as well.

Nice night in Idaho,
-Laura
 
I have a question about teeth. I go get my cleaning every 4 months. I have bone loss and in order to prevent it from going any further, the dentist prescribed periostat to take twice a day for three months. I understand it wrecks havoc with my coumandin levels and I have to go more often for my INR's. I was wondering if anyone had this same experience.
Consuela
MVP St. Jude 2005
 
I have a question about teeth. I go get my cleaning every 4 months. I have bone loss and in order to prevent it from going any further, the dentist prescribed periostat to take twice a day for three months. I understand it wrecks havoc with my coumandin levels and I have to go more often for my INR's. I was wondering if anyone had this same experience.
Consuela
MVP St. Jude 2005

WARFARIN SODIUM (in Coumadin Tablets) may interact with DOXYCYCLINE (in Periostat Tablets)

Blood clotting normally occurs in response to a cut or other types of injuries to protect the body from excessive bleeding. Many substances are involved in the clotting process including various chemicals that are produced in the body like vitamin K. Vitamin K is made by bacteria that are normally present in the intestinal tract and may also be supplied in the diet by eating green leafy vegetables, liver, and egg yolks. Doxycycline may kill the bacteria responsible for producing vitamin K. Warfarin is generally used to prevent your blood from "coagulating" or forming blood clots. When doxycycline and warfarin are used at the same time, your blood may be much less likely to clot and this may increase the risk of excessive bleeding. If these drugs are used together, your doctor may want to monitor you closely for signs of bleeding (bruising, nose bleeds, ect). Blood tests can be used to make sure that you are getting the right amount of warfarin. If you are experiencing problems, it may be necessary to adjust the dose of warfarin. Ask your healthcare provider about these drugs and this potential interaction as soon as possible.

This interaction is poorly documented and is considered major in severity.

Last Updated: June 2008

http://www.drugdigest.org/DD/Intera...10&dN="Coumadin+Tablets"+"Periostat+Tablets"+

Like everything else, it will have to be adjusted for.
 
Thanks for the info on sugarless gum Kristy. I am semi-addicted to it...lol...

I have suffered badly from dry-mouth ever since my surgery. Its much more noticeable at night and I drink a large bottle of water overnight everynight. I will keep up with the sugarless gum since it helps with the nasties. At least now I have a really good legitimite "medical/dental" reason for the gum.
I had always blamed my 5 days on the ventilator for my dry mouth , thinking they must have upset something there. I always have this weird taste in my mouth too ever since surgery. I have never seen anything relating it to the warfarin.

My teeth have always been delicate so I cant blame that on the warfarin.
 
I have a question about teeth. I go get my cleaning every 4 months. I have bone loss and in order to prevent it from going any further, the dentist prescribed periostat to take twice a day for three months. I understand it wrecks havoc with my coumandin levels and I have to go more often for my INR's. I was wondering if anyone had this same experience.
Consuela
MVP St. Jude 2005

Consuela,

I have taken doxycycline to combat perio disease. It did raise my INR a bit, but nothing to cause a change in my warfarin dose. The thing to remember is test about a week after starting a new medication, or stopping one you've been taking for a while. And adjust your warfarin dose accordingly.
 
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