Dental Cavities on Prednisone

@laura1970 I have been on and off prednisone due to PMR, mainly on, for 35 years and I am a dentist. I have not had dry mouth or a problem with dental caries. The only study I could find related to dry mouth and corticosteroids was done in rats and used dexamethasone which is much stronger than prednisone. I do not doubt your dry mouth I just wonder about the cause. Prednisone is given for auto immune diseases and some of those diseases cause dry mouth. Again there may be a connection between prednisone and dry mouth and this would be a good forum to learn about it. I personally have not experienced it or know of studies that prove it, but I am all ears.

@jfannarbor i was an internist for many years. Xerostomia from prednisone was not taught at my medical school. After practicing for some while I noticed a percentage of my patients on long term prednisone did complain of it. I usually tied it to another medication they were taking. I did, one day look it up in goodman and gillman ( did u relay on this book in dental school, just curious) and found it was a side effect, listed as less common. The following is from AI:

Prednisone, a synthetic glucocorticoid, impairs salivary gland function primarily through long-term use, leading to reduced saliva production. It diminishes store-operated calcium entry (SOCE) in salivary acinar cells, which is essential for fluid secretion triggered by intracellular calcium signaling.

From a different AI source:

Long-term use inhibits store-operated calcium entry (SOCE) in salivary acinar cells, reducing intracellular calcium levels essential for saliva secretion. This occurs when prolonged corticosteroid exposure diminishes calcium influx after endoplasmic reticulum depletion, without altering key membrane proteins like TMEM16A, AQP5, or NKCC1.[pharmacytimes +1]
Supporting Factors
Corticosteroids may thicken saliva or affect the sympathetic nervous system, limiting flow, though this is less specific to prednisone. Short-term use typically spares salivary function, with effects prominent after weeks.

Sorry I didn’t look up specific studies.

@laura1970 As I may have mentioned I went to PubMed and crossed prednisone with dental caries and the only related study was in rats and it did show reduced saliva when rats were given dexamethasone. I went to Drugs.com and searched prednisone side effects. Of the 2000 words written about side effects it did mention "dry mouth" under incidence unknown. It is shocking all the side effects of prednisone including heart attack. I am estimating that there were 100 to 200 side effects mentioned. After being on and off prednisone for 35 years, mostly on, I feel very lucky that the only side effect I had was thin skin.

@jfannarbor that is lucky. The majority of my patients experienced weight gain which I attributed to a combination of prednisone and decreased activity due to their underlying disease. Depending on the dose, a significant , but less than the majority of, developed moon facies.

@jfannarbor that is lucky. The majority of my patients experienced weight gain which I attributed to a combination of prednisone and decreased activity due to their underlying disease. Depending on the dose, a significant , but less than the majority of, developed moon facies.