More About Meds and Tooth Decay: Brush Several Times A Day

One of my most popular posts is the one about the dental problems that can result from taking meds for your brain.  As I said in that post, tooth problems aren't something that most pdocs even know about, let alone warn us about when we start taking crazy meds.  So you start a bunch of new meds for bipolar, depression, or ADHD, and suddenly your previously cavity-free mouth looks like that of a meth user.

I was at the dentist last week and learned something interesting, and a little counterintuitive, that I thought I should share with y'all: Drinking more water doesn't help your teeth.  I'd sort of assumed that it would.  I mean, if the problems are caused by your mouth being dry, wouldn't it make sense to make your mouth wet?

The problem with my hypothesis is that tooth decay, of course, is caused by bacteria.  Your mouth fights bacteria not with water, but with saliva.  Saliva has antibacterial properties.  Water does not.  Saliva also remineralizes your teeth, filling in any tiny pits that could develop into cavities later.  Water does not.  As my dentist said, "It just means you have to pee a lot".

My dentist recommends a lot of ways of dealing with this.  There's the high-flouride prescription toothpaste.  There are the mints and gum with xylitol in them, which stimulates saliva production.  Then there's plain old brushing.  By brushing your teeth several times a day, you get rid of that bacteria, and that prevents cavities.

Lamictal 300 mgs, Abilify 5 mgs: Bruxism is Back

When I first started lamictal I was overjoyed to find that I no longer ground my teeth.  After a few months on Abilify, the problems seems to have returned.  It's not as bad as when I was on zoloft, but it's still there.

Strangely (or maybe not), the problem really got noticeable when I switched to an ergonomic pillow for my neck.  My neck is pretty screwed up.  It will take any excuse it needs to tighten up and impinge the nerves in my arms and hands.  Hence the pillow.

The pillow seems to be helping my neck at the expense of my jaws.  I wake up, and my neck feels great -- but my jaws are clenched old school, and I can feel my teeth grinding.  When I was visiting my family last week this was even worse.  My mother uses these stiff damn pillows on the guest bed, which meant that both my neck and my jaws were screwed up.

I guess it's back to the mouth guard for me.

Lamictal 200 mgs: Bruxism is Back?

In a previous post, I wrote about how lamictal has affected my muscle tone.  I'm no longer stiff after working out, and my muscles in general are looser.  In the same post I wrote that my bruxism had improved a lot on lamictal -- I no longer seemed to grind my teeth at night, and my jaw wasn't clenched when I woke up in the morning.  This was pretty great, since I've ground my teeth my whole life.

In recent days, it seems like the bruxism is returning.  My jaw isn't clenched when I wake up, but the muscles there are a bit sore.  I'm not sure whether this is a side effect wearing off or not.  I certainly hope not.

So I'm currently testing a theory: that the jaw pain is actually related to stiffness in my neck.  I've been noticing for a few weeks now that my neck has been stiff in a way that once landed me in physical therapy, where I got a lecture about proper sitting posture while working at a computer (or playing a keyboard instrument, which was the real issue at the time).

Ironically, I think this problem arose because I was trying to be more ergonomically correct.  Generally, I'd been working on the couch with my laptop.  A few weeks ago, when I started using my sun lamp in the mornings, it was easier to set it up on my studio table than to prop it up next to me on the couch.  And anyway, using an ergonomically designed external keyboard should be better for me, right?

I now think I was wrong.

Crazy Meds, Dry Mouth, Bruxism, and Tooth Decay: What Your Doctor Didn't Tell You

Today at The Lamictal Diaries, we're going to talk about one of those things your doctor probably didn't tell you when you started taking your brain medicine.  We're going to talk about the massive dental problems that can result from taking SSRIs, stimulants, mood stabilizers, or antipsychotics.

Yup.  Dental problems. Your doctor probably knew to tell you that some of the most common side effects of your medication are dry mouth and teeth grinding.  Most med students, however, don't spend that much time learning about teeth in med school, which means that most doctors don't think of side effects in terms of how they'll impact your dental health.  Most doctors simply don't know that dry mouth and teeth grinding (also called "xerostomia" and "bruxism" respectively) are not trivial annoyances, but potentially serious conditions that can have a serious impact on your quality of life.   Over time, these conditions can lead to tooth decay, receding gums, tooth fracture, and ultimately, tooth loss.

You probably already know that a key part of managing your mood disorder is to reduce stress and anxiety in your life.  Getting cavities, cracking a tooth, or going to the dentist for painful procedures are sort of the opposite of that.  So what can you do to prevent your mental health from destroying your dental health?  And why am I on about this anyway?

Day 37: NorthStar Lamotrigine Side Effects

I spent all last week bitching about it, but in case you missed all that, my lamictal titration was interrupted by a change in generic brands, from Teva to NorthStar.  Back when I first started lamictal, my pdoc told me that generic lamotrigine  can vary significantly in bioavailability.  Teva lamotrigine, he explained, is the only generic that's remotely equivalent to brand-name lamotrigine.  The pills made by other manufacturers can have up to 20% less of the medication in them.

I spent all last week on NorthStar lamotrigine.  Allegedly, I was taking 75 mgs a day.  My psychiatrist wonders if my body was getting any of the med at all.  It was doing bugger-all for my mood, but there still seemed to be side effects.  Here's what I noticed:

Muscle stiffness, teeth grinding and lamictal/lamotrigine

A lot of people have reported muscle stiffness when taking Lamictal/lamotrigine.  Jared Poole of the inestimable CrazyMeds describes them this way:

... everything from just a twinge in your neck or back to full-body aches that make you wonder if you were possessed by some spirit that made you participate in a triathalon the day before and have no memory of it.

This had me concerned.  As I've mentioned before, I'm a weight lifter, and DOMS (delayed-onset muscle stiffness) was already a problem for me.

Wonder of wonders; lamotrigine (so far) seems to be improving my general muscle stiffness!  Yay!  DOMS is nowhere near as bad as it used to be.  Using the foam roller after working out doesn't have be swearing like a sailor because of the pain.  

But the real miracle is that my bruxism seems to be significantly diminished, maybe even gone entirely.  I've ground my teeth for as long as I can remember.  Getting my wisdom teeth removed helped somewhat, but my dentist still prescribed a mouth guard to wear at night.  Being on SSRI's and stimulants didn't help this at all, of course, but I've ground my teeth even when I've been taking no drugs for my brain.  

I can't tell you how nice it is to wake up without my jaw clenched.