Plaquenil, the brand name for hydroxychloroquine, is a medication used to manage autoimmune conditions like lupus and rheumatoid arthritis. It functions by adjusting the immune system to reduce inflammation and prevent disease flare-ups. While effective, it is associated with certain side effects, including some that impact oral health.
Oral Pigmentation Changes
One of the documented side effects of long-term Plaquenil use is hyperpigmentation within the mouth. This is a rare reaction for those on the medication for extended periods. The pigmentation typically manifests as blue-gray or black patches, most frequently observed on the hard palate, which is the roof of the mouth.
While the soft tissues are the most common sites for these changes, discoloration of the teeth themselves can also occur, though less frequently. The mechanism involves the drug stimulating melanin production or depositing into the soft tissues. Individuals should monitor for any new discoloration and report it to their healthcare provider or dentist.
Impact on Saliva and Gum Health
Plaquenil can indirectly affect dental health by contributing to dry mouth, a condition known as xerostomia. While this may be linked to the underlying autoimmune disease, decreased salivary flow is a concern. Saliva has a protective function; it helps neutralize acids, washes away food particles, and contains antimicrobial components that limit harmful bacterial growth.
A reduction in saliva compromises these natural defenses, creating an environment where dental problems are more likely to develop. Without adequate saliva, the risk for tooth decay increases. This dry environment can also lead to inflammation of the gums (gingivitis) because bacteria can accumulate more easily along the gumline.
Managing Dental Health on Plaquenil
Proactive management is important to mitigating the potential oral health risks associated with taking Plaquenil. This begins with a rigorous oral hygiene routine, including brushing at least twice a day with a fluoride toothpaste and flossing daily. These practices are essential for removing plaque and food debris that accumulate in a dry mouth.
To specifically address dry mouth, individuals should stay well-hydrated by drinking plenty of water. Chewing sugar-free gum or using sugar-free lozenges can help stimulate saliva production. In cases of persistent dryness, over-the-counter saliva substitutes can provide temporary relief. Limiting the consumption of sugary foods and acidic drinks is also advised, as these can accelerate tooth decay when saliva’s protective qualities are diminished.
It is important for patients to inform their dentist that they are taking Plaquenil. This allows the dental team to be more vigilant in monitoring for early signs of pigmentation, decay, or gum disease. Regular dental examinations, ideally more frequent than once a year, enable the dentist to provide tailored preventive care and address any potential dental side effects promptly.