Teeth

There is a lot of information out there, and even on this blog, about side effects of psych meds.  One that gets ignored a lot is the damage to teeth.  Having dry mouth all the time is hard on your teeth. 

I am fortunate to have a dentist who is knowledgeable about psych meds because his brother is also bipolar.  So when I first went to see him and my front teeth had something like 28 cavities/pre-cavities because of years of vomiting from lamictal and lithium and then 6 months of vomiting daily from lithium toxicity, he didn't blink, he just fixed them.  My front teeth are great looking but they are mostly porcelain.  In the first week I knew my dentist I had those 4 teeth repaired and then numerous other fillings.  I was in their office daily for a week.

Since then I have broken 2 teeth by cracking them deeply, one clear to the bone, by grinding my teeth.  That happens with stress but it is also a side effect of multiple psych meds.  One tooth has a crown and the other has a root canal and crown.  That one nearly landed me in a hospital because my impaired pain tolerance (also probably medication related) made me ignore the pain until it was badly infected.  After that I got a bite guard but I have a hard time wearing it.  Everything dental is complicated by my gag reflex.  It's a common problem in people who have been sexually abused and I think that knowing that is why my dentist is so very kind about keeping things as calm as possible for my visits.  The tooth that just has a crown is fairly painful and I suspect that I'm going to be getting a root canal.  I have been having pain for a while but it has gotten a lot worse in the last week and tonight it is just painful and the gumline looks icky.  I don't know if they are in tomorrow but I may have to face it and go.

Stress injuries aren't the only problem though.  I am currently sitting here doing a home fluoride treatment that I am supposed to do nightly.  However it involves the stuff staying on your teeth for 30 minutes and I can't always manage.  But it is important because 2 of my teeth are losing enamel because of the dry mouth.  My dentist said he is "worried about me" because my potential for big problems seems to be great.  I have 2 or 3 more fillings that need to be done but I don't have insurance coverage for that until April.  I have a bunch of sensitive teeth, again probably from dry mouth.

They did give me a few things to help with dry mouth.  Taking a probiotic and calcium supplement can help.  I was already doing that.  I was told to switch to a toothpaste with baking soda (I'm using Mentadent) and if I could find a gum with baking soda that this would help a lot.  Apparently they used to give it out as samples but what they had isn't made anymore.  However I found some called Ecodent on Amazon and I chew it a lot when I'm not near water.  It truly does help although buying gum in bulk feels weird ($20 of gum???? But it is a lot of gum).

I'm a little scared tonight of what else can happen with teeth.  I hope I'm wrong about needing a root canal, especially since this tooth is already crowned and a root canal could potentially mean a new crown plus the root canal, all out of pocket.

I'm also afraid that I will start to lose teeth due to this.  Back when I had my root canal and 2nd crown someone at work asked why I wasn't just getting it pulled.  The simple reason is the dentist wants me to keep as many teeth as possible.  Between grinding and breaking them (I chip my teeth as well as cracking molars so I am constantly needing things evened out) and the weakness in the enamal it's a little scary.  The dentist also says tooth strength and enamal strength are partially hereditary and that's not a good thing either.

But mostly......psych meds hurt teeth.  Ugh.