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| Overview: |
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Extensive research over several decades has explored the interactions between various foods/beverages and prescribed or non-prescribed drugs, uncovering side effects, alterations in drug bioavailability and nutrient absorption as well as their impact on conditions such as tooth decay. |
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Global surveys highlight widespread untreated caries, with peaks at 6, 25, and 70 years, the latter associated with increased root caries. |
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Key risk indicators for elderly caries encompass past root caries, surfaces at risk, poor oral hygiene, gender, age, periodontal disease, and nutritional discrepancies. |
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| Essential Micronutrients in Older Adults: |
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As life expectancy rises, proper nutrition becomes vital for older adults to manage chronic diseases. |
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Micronutrients like omega-3s, vitamins, and minerals support metabolism, immune function, and bone health. |
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Nutrients such as β-glucans and CoQ10 play roles in immunity and cell health, with CoQ10 deficiency linked to oral problems. |
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Nutrient-drug interactions can impact drug effectiveness, highlighting the need for careful management of diet and medications in older adults. |
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| Polymedication in Older Adults: |
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Prolonged utilization of medications and dietary supplements carries the potential to instigate both clinical and subclinical nutritional deficiencies. |
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| Host–Drug–Oral Microbiota–Nutrient Interactions: |
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Microbiota can transform drug structures, impacting individual drug responses. This complexity is heightened by the concurrent use of probiotics, prebiotics, synbiotics, postbiotics, and antibiotics. |
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The oral microbiota is crucial for oral health, influencing conditions like periodontal disease and caries. |
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Systemic diseases, including diabetes, rheumatoid arthritis, and lupus, can exacerbate periodontal issues by altering oral bacterial balance. Emerging evidence links chronic diseases, such as diabetes and cardiovascular disease, with imbalances in oral microbiota, which may also be influenced by medications for these conditions. |
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| Effect of Elderly Medications on Dental Caries: |
| Medication |
Nutrient Impact |
Oral Health Effects |
| Statins |
Lowers Coenzyme Q10, Vitamins A, D, E, K |
Gum inflammation, higher periodontal risk. |
| PPIs |
Reduces Vitamin B12, C, calcium, iron, magnesium |
Weakens oral and bone health. |
| Metformin |
Depletes Vitamin B12 |
Nerve issues, taste changes, mucosal health. |
| SSRIs |
Decreases calcium, sodium |
Dry mouth, tooth decay, reduced bone density. |
| ACE Inhibitors |
Reduces potassium, magnesium, zinc |
Xerostomia, weak teeth, increased caries. |
| Corticosteroids |
Lowers calcium, potassium |
Tooth decay, higher gum disease risk. |
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| Drug Class |
Frequency of Dental Caries |
| Antidepressants |
High |
| Antipsychotics |
Moderate |
| Antihypertensives |
Low |
| Analgesics/opioids |
High |
| Antihistamines |
Moderate |
| Antacids |
Low |
| Immunosuppressants |
Moderate |
| Anti-diabetic Medications |
Moderate |
| Antibiotics |
Low |
| Corticosteroids |
High |
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| GGI-CO-A1-AQS-300032384-DVC-L24-0140 |
| Reference: |
| 1. |
Bell V, Rodrigues AR, Antoniadou M, Peponis M, Varzakas T, Fernandes T. An Update on Drug–Nutrient Interactions and Dental Decay in Older Adults. Nutrients. 2023; 15(23):4900. https://doi.org/10.3390/nu15234900 |
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