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← Return to Dental Cavities on Prednisone
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As a dentist, I do not know of any relationship between prednisone and tooth decay. Tooth decay has been well researched. The three absolute requirements are: 1 refined carbohydrate, 2 streptococcus mutans and, 3 tooth structure. Without any one of the 3 above items there cannot be tooth decay. I do not know of any relationship between the above three and prednisone. Without knowing your personal situation my first guess is you are going to a new dentist. My experience is if you go to a new dentist that does not know your caries rate and they will try to fix every minor defect. Caries in most people can be completely controlled with good oral hygiene. Does your dentist or hygienist review you oral hygiene at each visit? If you do not know the quality of your oral hygiene you can not correct any defects. My daughter is 42 and has no cavities or fillings due to her diet and oral hygiene. She obviously has a low caries rate. I have told her if a dentist ever tells her she needs a filling, get a second opinion. Caries free individuals at 42 are not going to get any cavities unless their diet or oral hygiene changes
Replies to "As a dentist, I do not know of any relationship between prednisone and tooth decay. Tooth..."
@jfannarbor I agree completely with your statement.
Additionally I always told my patients that as far as your teeth are concerned it’s not the amount of sugar or carbs that affects your teeth but the frequency that you’re repeating. Once you take the first bite of cake you can eat the entire thing and it won’t be worse than the first bite as far as your decay rate. The patients that get the worst decay are those that take small amounts of sugar repeatedly throughout their day ie, Tic Tacs, or jelly beans, etc.
Once you put any sugar in your mouth it takes about 45 minutes for your saliva to neutralize the acid formed by the bacteria. If you then repeat that every hour because the gum has lost its flavor or your “ snacking” etc. because you think your breath is bad that’s where we saw patients with rampant decay.
Same principle of not putting a baby to bed with a juice bottle or anything sweet as it ruins their primary teeth.
Prednisone does cause dry mouth in some patients and that will/ can cause an increase in their decay rate as it’s your saliva that works to neutralize any acid formation from the carbs etc. If you’re using breath mints or anything with sugar to combat your dry mouth it will exacerbate the problem.
This study focuses more on dental caries and long term corticosteroid use.
https://pmc.ncbi.nlm.nih.gov/articles/PMC10475248/
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No research ever provides definitive answers to these questions and this one is no exception. This study suggests steroid inhalers are mostly the problem.
"Future randomized controlled clinical studies are warranted to confirm these findings."
@jfannarbor it is my understanding that prednisone causes xerostomia (dry mouth) which is linked to gum disease and cavities. Am I misinformed?
For medication induced dry mouth, I take biotine. I tolerate it much better than saliva substitutes. What is your recommendation for dry mouth?
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@jfannarbor
I would be the first to admit that I don't know anything about it. My dentist didn't know what changed but I had an increase in cavities when I was on Prednisone. My dentist was conservative when it came to fillings so she would commonly put a "watch" on potential problems.
Those things she put a watch on turned into cavities rather quickly. The solution was more frequent visits and cleanings---every 3 months. My dentist got my dental insurance to approve frequent visits because of medical reasons.
I don't think I had "new cavities" very often but frequent revisions of old fillings that "leaked." I got the impression it was the tooth structure around the fillings that was the problem.
In any case, my dentist wondered if Prednisone was causing my problems. My dentist thought prednisone could affect the oral environment, which likely contributed to changes in my mouth's biome and a dry mouth.
What is your take on the following research? I don't know if it is credible or not.
https://juniperpublishers.com/adoh/ADOH.MS.ID.555801.php
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I suspect more research is needed.