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Lithium Dental Side Effects

If you or a family member have recently received a diagnosis of bipolar disorder, you most likely have many questions about treatment, how effective it will be, and what its potential side effects are. For more than 60 years, medical professionals have used lithium to treat bipolar disorder successfully. With proper management and monitoring, lithium medication can be a life-changing treatment. It's instrumental in patients with bipolar I disorder who frequently experience mania, the more severe symptom of this disorder.

However, this treatment does have some adverse effects – including lithium dental side effects. Let's go over the prevalence of bipolar disorder, its side effects, both short-term and long-term, and how best to care for your mouth while on this medication. We know that the road to diagnosing bipolar disorder probably wasn't a smooth one, but you've made it here! We're here to guide you with helpful knowledge as you begin the treatment journey.

Prevalence of Bipolar Disorder

The Depression and Bipolar Support Alliance (DBSA) recognizes that about 5.7 million adults in the United States have bipolar disorder. So if you or a loved one have received this diagnosis, we hope this statistic demonstrates that you are far from alone! While bipolar disorder 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. According to the DBSA, bipolar symptoms can be successfully treated with lithium in 40 to 50 percent of people after receiving the proper diagnosis.

Dental Side Effects of Lithium

  • Dry mouth (xerostomia) is caused by an underproduction of saliva. It prevents the teeth and soft tissues in the mouth from being adequately lubricated. Saliva also acts as a buffer for acidic foods and drinks and contains essential minerals to keep the enamel strong.
  • People are more susceptible to particular dental issues when they lack saliva from lithium, such as tooth decay, gingivitis, and gum disease. The gums and other oral tissue can become red, inflamed, and ulcerated, making it painful to eat and follow a proper oral hygiene regimen.
  • Additionally, bipolar disorder often causes over-brushing, damaging the gums, and cause tooth abrasion.

Short Term Bodily Side Effects of Lithium

Lithium can cause both oral and full-body side effects. Initially, when a person begins drug therapy, there's a chance that short-term side effects can occur. Note that these issues can diminish when dosing is regulated but can reoccur if they increase their dose. Short-term lithium side effects include:

  • Tremors
  • Fatigue
  • Diarrhea
  • Frequent urination
  • Weight gain
  • Reduced sex drive
  • Reduced mental clarity
  • Dermatologic issues like acne and psoriasis can occur. If a person already had dermatological problems before lithium treatment, their condition can become exacerbated when they begin treatment.

Long Term Bodily Side Effects of Lithium

Long-term side effects can be more problematic since they can cause irreversible changes in the body. The organs that are most affected by long term lithium treatment are the kidneys and the thyroid and parathyroid glands:

  • With the kidneys, lithium alters the concentration of fluids, leading to excessive urination and thirst, leading to a feeling of dry mouth or dehydration. In most cases, lithium's renal effects are mild. Excess thirst and urination are typical short-term side effects of taking lithium. But it becomes a longer-term issue for about 20 to 25% of people, as noted by Harvard Medical School.
  • The Mayo Clinic states that thyroid and parathyroid gland function can become diminished while taking lithium. This can cause hypothyroidism and hypercalcemia (an excess of calcium in the blood). Hypothyroidism causes tiredness, weight gain, depression, and lack of mental clarity. Hypercalcemia can cause pain and muscle weakness or create kidney stones. In rare cases, it can interfere with how your brain and heart function.

However, these potential long-term side effects are by no means reasons to stop taking lithium. A medical professional can closely monitor a person with these conditions and can treat them if necessary.

No matter what other health conditions you are managing, regular professional dental care and an effective at-home oral care routine are essential. Brush twice daily using a soft-bristled toothbrush and a toothpaste that contains fluoride. Clean between your teeth once a day with floss, a water flosser, or another interdental cleaning tool, then finish your oral care routine with a mouthrinse to rinse away any remaining bacteria. Ask your dental professional for products that might help manage your side effects.

Managing Treatment

From shock to frustration, you may experience a myriad of emotions upon learning of a bipolar disorder diagnosis. We understand the process of managing one's mental health can feel like an uphill battle. But be confident that you are on the right path, taking appropriate steps to diagnose and treat your disorder while learning to manage the side effects of treatment.

As you progress along your journey of stabilizing your bipolar disorder, or help a loved one manage theirs, know that experiencing side effects is part of the process. Work with both medical and dental professionals to understand lithium, teeth issues, and other side effects. You're learning to integrate your mental, oral, and physical health. That's something to be proud of!

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This article is intended to promote understanding of and knowledge about general oral health topics. It is not intended to be a substitute for professional advice, diagnosis or treatment. Always seek the advice of your dentist or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment.

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