ANTICHOLINERGICS AND ORAL HYGIENE

YUVASHREE. S. R.

FIRST YEAR POSTGRADUATE

MDS (DEPARTMENT OF ORTHODONTICS)

ticholinergics are drugs

that block the action of
acetylcholine and can cause
a variety of peripheral side effects,
such as dry mouth
caused by a reduction in the flow
of saliva, and central
side effects, such as cognitive
impairment or worsening
of tardive dyskinesia [2]. Harmful
cumulative effects
from anticholinergic drugs might
have already impacted
people with one clinical condition
[3]. Furthermore,
anticholinergic adverse effects
increase with increasing
the dose, and multiple low-level
anticholinergic drugs
can add up to the same
anticholinergic burden (or more)
than a single high-level
anticholinergic drug [4, 5]. This
potential for harm increases with
frailty and age [6], and
the anticholinergic drug use is
closely related to serious
negative outcomes for people
using these drugs [7]. As far
as we know, various
anticholinergic burdens or risk
scales
have been devised, but no single
standard anticholiner
 Anticholinergic drugs are prescribed for a wide range of conditions
such as overactive bladder, chronic obstructive pulmonary disease,
nausea and vomiting, depression and psychosis.
 Anticholinergics are drugs that block the action of acetylcholine
and can cause a variety of peripheral side effects, such as dry
mouth caused by a reduction in the flow of saliva, and central side
effects, such as cognitive impairment or worsening of tardive
dyskinesia.
Furthermore, anticholinergic adverse effects increase with increasing
the dose, and multiple low-level anticholinergic drugs can add up to the
same anticholinergic burden (or more) than a single high-level
anticholinergic drug. This potential for harm increases with frailty and
age, and the anticholinergic drug use is closely related to serious negative
outcomes for people using these drugs.

Anticholinergic burden is associated with poor oral hygiene status and

could affect oral hygiene in several ways.

 It can be speculated that the anticholinergic burden decreases

participant motivation and ability to remember to brush their
teeth twice a day due to a decline in cognitive functions.
 Anticholinergic burden may lead to insufficient removal of dental
plaque by lowering the patient’s attention and precision required
to carry out efficient tooth brushing.
 It could also be speculated that the effects of anticholinergic
burden on oral hygiene are mediated by hyposalivation, which is
thought to promote the development of dental plaque by
diminishing bacterial clearance from the oral cavity, by increasing
bacterial adherence to hard and soft tissues, and by reducing anti-
bacterial effects of saliva.

It should be emphasized that the current evidence on the topic of

hyposalivation is inconclusive, as there are studies both for and
against.