Use of psychotropic drugs and associated dental diseases

Int J Psychiatry Med. 2014;48(3):185-97. doi: 10.2190/PM.48.3.d.


Patients with problems related to central nervous system dysfunctions are often treated with psychotropic drugs. These include antipsychotics, antidepressants, mood stabilizers, anticonvulsants, and drugs blocking specific receptors in the brain such as anticholinergics or beta-blockers. However, these medications have serious side effects affecting the oral health. In addition, many dental patients make use of psychoactive drugs, such as amphetamine, ecstasy, and cocaine. This article aims to review data on the psychotropic drugs being used in the last 30 years, their pharmacological profile, with special attention to the side effects related to the oral health. Oral diseases such as bruxism, orofacial dystonia, oromandibular dyskinesia, and rabbit syndrome are related to extrapyramidal effects of antipsychotic drugs because of their antagonist activity on the dopaminergic receptors. Drugs with anticholinergic and/or antiadrenergic effects such as tricyclic antidepressants may cause dry mouth and related complications such as candidiasis and other oral infections. Among mood stabilizers, lithium treatment induces a wide range of side effects on oral system including dry mouth, sialorrhea, infections, and ulceration of the oral cavity. Psychostimulants may instead provoke xerotomia, gingival enlargements, bruxism, dental erosion, mucosal ulceration, and oral/nasal lesions. This literature review supports the idea that the higher prevalence of oral diseases among patients with mental disorders may be attributed to the side effects of their medications mediated by complex interactions between different targeted receptors. Thus, dentists must be aware of the possible risks of these medications in order to take appropriate precautions in treating these patients.

Keywords: central nervous system dsyfunctions; dental diseases; psychotropic drugs.

Publication types

  • Review

MeSH terms

  • Basal Ganglia Diseases / chemically induced
  • Basal Ganglia Diseases / epidemiology
  • Comorbidity
  • Cross-Sectional Studies
  • Humans
  • Mental Disorders / drug therapy*
  • Mental Disorders / epidemiology
  • Mouth Diseases / chemically induced*
  • Mouth Diseases / epidemiology
  • Oral Health
  • Psychotropic Drugs / adverse effects*
  • Psychotropic Drugs / therapeutic use
  • Risk Factors
  • Stomatognathic Diseases / chemically induced*
  • Stomatognathic Diseases / epidemiology


  • Psychotropic Drugs