Bipolar disorder has been successfully treated with lithium for more than 60 years. With proper management and monitoring, lithium medication can be a life-changing treatment. According to the Australian Prescriber, lithium is particularly effective in patients with bipolar I disorder who experience episodes of mania and depression interspersed with periods without symptoms. However, this treatment does have some adverse effects – including lithium dental side effects.
Lithium Dental Side Effects
The Depression and Bipolar Support Alliance (DBSA) recognizes that over 5 million adults in the United States suffer from bipolar disorder. While it affects men and women equally, women seem to exhibit signs of "rapid cycling" of the symptoms more often, as well as longer-lasting depressive episodes. The median age for diagnosis is 25, but it is not uncommon for a diagnosis to come as late as age 40 or 50, or as early as childhood. Bipolar symptoms can be successfully treated with lithium in 40 to 50 percent of patients after the proper diagnosis is made, says the DBSA.
Lithium can cause both oral and full-body side effects. Initially, when a patient begins drug therapy, the International Journal of Bipolar Disorders writes that short-term side effects like tremors, fatigue, diarrhea, frequent urination and dry mouth are common. Dermatologic issues like acne and psoriasis can occur, or patients who previously experienced these skin problems can find their conditions are exacerbated. These issues can diminish when dosing is regulated, but can reoccur if the dose is increased. Other immediate effects reported by bipolar sufferers include weight gain, diminished sex drive and reduced mental clarity.
The journal reports that long-term side effects can be more problematic since they can cause irreversible changes in the body. The organs that are most affected are the kidneys and the thyroid and parathyroid glands. With the kidneys, lithium alters the concentration of fluids, leading to excessive urination and thirst. In most cases the renal effects of lithium are mild, although permanent kidney damage has been reported.
The Mayo Clinic notes that thyroid and parathyroid gland function can be diminished while taking lithium, causing hypothyroidism and hypercalcemia (an excess of calcium in the blood). The incidence of hypothyroidism is increased by at least sixfold with lithium, causing tiredness, weight gain, depression and lack of mental clarity. However, it is by no means a reason to discontinue medication. A person with these conditions can be closely monitored and treated with thyroid hormone replacement, if necessary. The symptoms of hypercalcemia include tiredness, kidney problems and osteoporosis. This condition can be a potential contraindication for lithium use, and regular blood plasma monitoring for calcium concentrations is recommended.
With bipolar medication, writes New Life Outlook, one of most common dental risks is dry mouth, or xerostomia. A lack of saliva prevents the teeth and soft tissues in the mouth from being properly lubricated. Saliva also acts as a buffer for acidic foods and drinks and contains essential minerals to keep the enamel strong, meaning a lack of saliva makes a person more susceptible to decay, gingivitis and gum disease. The gums and other oral mucosa can become red, inflamed and ulcerated, which makes it painful to eat and follow a proper oral hygiene regimen. Additionally, bipolar disorder often causes over brushing that may damage the gums and cause tooth abrasion, says New Life Outlook.
No matter what other health conditions you are managing, regular professional dental care and good oral care at home are essential. Brush twice daily using a soft-bristled toothbrush and a toothpaste that contains fluoride. Ask your dental professional for products that might help manage your side effects. Your dentist and dental hygienist can monitor your mouth and teeth for changes and help integrate oral care into your overall health.