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Blood pressure meds and gum problems
An_248325 posted:
I understand that taking certin types of blood pressure meds can affect your gums...what can you do about that?
Gwen Cohen Brown, DDS, FAAOMP responded:
Hi An_248325, While there is a known response to blood pressure medication it does not develop in every patient. Gingival (gum) overgrowth has occured in patients taking beta blockers and ACE inhibitors as well as numerous other drugs that are not used for regulating blood pressure.

The good - or bad - news is that ginival overgrowth does not develop in all patients taking these medications, however, if gingival overgrowth does develop as a result of the blood pressure medication it can be difficult to treat and you will need to have your physician and dentist work together. There are two separate issues that need to be addressed.

You need to know that the gingival overgrowth is neither dose or time related, in other words if you are going to develop gingival overgrowth secondary to a specific medication - because you are susceptible - you are going to get it and it does not matter how long you have been taking the medication or what dose (size of pill) the pill is.

The other issue is that once you have developed gingival overgrowth to one beta blocker the likelihood is that all beta blockers will result in gingival over growth. The same goes for ACE inhibitors, if you develop a gingival overgrowth to one ACE inhibitor chances are the entire category of medication will cause you to develop gingival overgrowth. So if you are taking a beta blocker to treat your high blood pressure you cant switch to a different beta blocker as all of the beta blockers will cause you to develop gingival overgrowth. The same goes for the ACE inhibitors.

As you can imagine this presents problems for the patients cardiac care. If the only medication that is effective in treating a patients high blood pressure is a beta blocker and beta blockers cause that specific patient to develop gingival overgrowth the regulation of blood pressure trumps the gum disease. If the patient can be treated with a different classification of high blood pressure medication then great, switch the classification of medication, the gingival overgrowth will need to be treated but should not recur with the new medication, so if you are on beta blockers and you develop gingival overgrowth you can switch to an ACE inhibitor and visa versa.

If you can't switch to a new blood pressure medication in a different classification you must understand that the gum tissue will continue to grow as long as you are taking that specific medication to treat the high blood pressure.

Either way you will need to treat the gingival overgrowth as it will not go away on its own. Your dentist or periodontist (gum specialist) will need to remove the gingival overgrowth. Once it is healed you will need to maintain scrupulous oral hygiene and ideally you should see a dental hygienist three to four times a year. This is the only way to prevent bone loss in under the affected gingiva and subsequent loss of teeth.

I realize that this is a very long answer to a very short question, however it is complicated. The main thing to remember is this; your heart health is more important than your oral health and which ever high blood pressure medication is the most effective for you is the one you should use. Any oral problems that develop as a result of the medication can be treated by your dentist and dental hygienist.

I hope this helps. Let me know if you have additional questions.

Dr. Gwen Cohen Brown

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