217 The Development of an Oral Health Nursing Tool in Patients with a Psychotic Disorder Medications, Side Effects, and Their Impact on Dental Health As previously mentioned, side effects of antipsychotics (e.g., clozapine, olanzapine, quetiapine) can cause dry mouth (xerostomia) or insufficient saliva (hyposalivation). The most common cause of xerostomia is the use of medication with an anticholinergic effect (antipsychotics). Adjusting the medication can reduce or even eliminate the symptoms, but this is not always possible. Patients with a dry mouth can also experience problems with chewing, swallowing, speaking, teeth grinding, and/or sleeping. Therefore, it is important to be extra alert for these symptoms. However, recognizing them is not easy, as patients are often unaware of reduced saliva production. Before patients experience related problems, saliva production is often already reduced by half and damage may have already occurred. See the tips for what to do! Problems in the Mouth Many issues can arise in the mouth, including cavities, irritated or inflamed gums, periodontitis, bad breath, and tooth erosion. • Cavities. The formation of cavities is a significant side effect of medication that can cause lasting damage to the teeth. Cavities from medication can sometimes develop within weeks to months after starting the drug. The primary cause of medication-induced cavities is reduced saliva secretion. Nearly 90% of antipsychotic medications lead to a dry mouth due to reduced saliva. Tablets (such as XyliMelts) can help to reduce dry mouth symptoms. • Inflamed gums (Gingivitis). Healthy gums are pink. Inflamed gums are redder in colour, more swollen, and bleed more easily during brushing and when using floss/toothpick/interdental brush. A bad taste or bad breath can also indicate inflamed gums. Inflamed gums rarely cause pain. The inflammation at the edge of the gums is caused by bacteria in plaque, to which the gums react. Plaque calcifies into tartar and adheres firmly to the teeth and molars, forming a new layer. This cannot be removed by an individual and requires a dentist or dental hygienist. If not treated, the inflammation can damage the jawbone, leading to bone loss. Inflamed gums are preventable and curable with good oral hygiene. Bleeding gums means there is inflammation. This signal should not be ignored, 6
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