Impact of antipsychotic medication on oral health

Dental Tribune International

Fri. 15. August 2025

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BILBAO, Spain: While the systemic health implications of neuropsychiatric disorders are well recognised, their connection to poor oral health—in particular, the direct effects of antipsychotic drugs on the oral cavity—has received comparatively little attention. Filling the gap, a new study from the University of the Basque Country in Bilbao has provided detailed insight into the oral side effects associated with antipsychotic medications. It found that these drugs are frequently associated with disturbances in salivary flow, inflammation and tooth loss and that specific medications are linked to distinctive oral conditions.

Using the European EudraVigilance database, the study examined suspected oral adverse effects reported in association with both typical and atypical antipsychotic medications, identifying 5,663 cases linked to atypical drugs and 787 to older typical agents. Although newer antipsychotics were associated with a higher number of reports overall, older drugs showed stronger associations with certain oral health conditions.

Disturbances in salivary flow emerged as the most frequently reported problem, and xerostomia and hypersalivation were commonly observed. Olanzapine and quetiapine were often linked to xerostomia and tooth loss, and clozapine was strongly associated with hypersalivation, accounting for 1,619 reports—the highest for any single drug. All antipsychotics, except clozapine, were linked to orofacial dyskinesia, and aripiprazole showed the strongest association with both this condition and tongue oedema in adolescents. Other reported oral conditions included dental caries, inflammation of the salivary glands and tooth loss. No sex-based differences in the occurrence of adverse effects were observed.

Although the findings show a clear association between antipsychotic use and oral health conditions, study co-author Dr Nerea Jauregizar from the University of the Basque Country’s Department of Pharmacology stressed that causality cannot be confirmed. This is because patients with mental health disorders often take multiple medications, including antidepressants, hypnotics and drugs for systemic conditions. Poor oral hygiene, substance abuse and limited access to dental care are also more prevalent in this group, compounding the risk of oral disease.

In light of the study findings, the authors emphasised the importance of integrating oral healthcare into the management of patients receiving antipsychotic therapy. They believe that systematic oral health checks and targeted support can improve quality of life, particularly for people with schizophrenia, who often face stigma and barriers to care. Preventive measures should focus on ensuring good oral hygiene and lifestyle habits, monitoring salivary function, addressing changes promptly, and fostering close collaboration between psychiatrists and dental professionals to detect and manage oral complications early.

The study, titled “Oral adverse effects of antipsychotic medications: A case/noncase analysis of EudraVigilance data”, was published online on 21 April 2025 in Oral Diseases, ahead of inclusion in an issue.