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Michael Sultan: Antidepressants

We’re living through what many are calling a ‘global mental health crisis’ – and it’s easy to see why. Recent times have been full of monumental change, not only setting the stage for global events such as war in Europe and the pandemic, but also smaller, ongoing problems such as the cost-of-living crisis. With so much pressure and stress, it’s little surprise that around 7% of the global population has depression.

Depression can affect our oral health. For instance, sufferers with depression may eat poorly, let oral hygiene routines lapse, and fail to attend dental care appointments. Current figures suggest that over 8.3 million people in the UK currently take antidepressants. This number is on the rise, and prescriptions for this type of medication increased substantially (by 5%) over the course of 2021 and 2022.

Some may take this as proof that more people are suffering from depression, while others might interpret this as a sign that more people are finally admitting they need help for a condition from which they may have been suffering for a long time.

What’s concerning about this, from an oral health perspective, is that new research from a team at the University of Buffalo has found that use of antidepressants could lead to significantly increased chances of dental implant failure. In fact, the risk of dental implant failure is seen to double for every year of antidepressant drug use.

There are a number of reasons for this. Common side effects of antidepressant medications include bruxism and dry mouth, both of which could interfere with a dental implant’s healing process. The study also revealed that antidepressant drugs can decrease regulation of the bone metabolism – an instrumental part of the healing process after dental implant placement.

Selective serotonin reuptake inhibitors (SSRIs), a type of antidepressant drug that works by increasing serotonin levels in the brain, are one of the most common types of antidepressant prescribed. Unfortunately, they are also the drugs that have been found to negatively affect bone density around the whole body, including bones essential to the success of dental implant therapy. But what does this mean for the future?

Dental implant therapy is becoming more and more popular. As the UK population continues to age (the median age has risen from 37.9 in 2001 to 40.7 in 2022) the demand for dental implant procedures has also increased. While there are no firm figures about the number of dental implants placed each year in the UK, back in 2012 the number was believed to be around 120,000 – and this has likely increased within the last decade.

There are challenging times ahead. The number of patients seeking dental implant therapy who are also on antidepressant medication is only going to increase, implying that failure rates will also be on the rise unless proper precautions are taken. We must try to ensure that patients are open and honest with us about any medications they are taking.

It’s important we broach the topic with compassion – there’s still a stigma attached to mental illnesses which might make our patients reluctant about sharing this information with a dentist, thinking we are all about oral health not their mental state. We need to explain why we need to know, outlining how these medications can cause complications.

We also have to remember that antidepressant use doesn’t automatically mean implant failure. If patients on these drugs are informed of the possible complications, we’ve done our part to ensure that they are aware of the increased chance of failure rates. From this point, the treatment journey will depend on what decisions they make, whether that means coming off the medications or exploring alternative dental treatment options.

In conclusion, as long as we’re open and honest, we can manage this situation as it develops.


Michael Sultan is the founder and principal of endodontic referral practice EndoCare, and is a regular contributor to Dental Review. For more information, call 020 7224 0999 or visit www.endocare.co.uk 

See the original article here: Dental Industry Review