Antidepressant medications and nutraceuticals: Effects on the success of dental implants

Kevin Oberlander, RPh, says, “As a pharmacist working closely with the dental profession, I read with great interest the recent pilot study conducted by the University of Buffalo that brings to light fresh concerns over the adverse effects in dental implant patients taking antidepressants.” In this article, he discusses research concerning the value of supplementing with nutraceuticals—specifically Vitamin D and magnesium—for patients with dental implants who are taking medications that cause deficiencies affecting bone health.

Apr 19th, 2016
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As a pharmacist working closely with the dental profession, I read with great interest the recent pilot study conducted by the University of Buffalo that brings to light fresh concerns over the adverse effects in dental implant patients taking antidepressants.

The study links antidepressant use to a four-fold increase in the odds of failure in dental implants, and also reports that each year of antidepressant use doubled the odds of failure.

The reported connection for patients with dental implant failure is due to the effect of antidepressants in decreasing the regulation of bone metabolism, which is critical to the healing process following an implant procedure. This detrimental effect on bone health adds to other known side effects of antidepressants, including osteoporosis, akathisia, bruxism, and dry mouth, all of which may further impede the implant healing process.

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Antidepressants are the second most widely prescribed medications in the United States, so it is important that the results from the pilot study are carefully examined in future research and that health-care providers understand the possible ramifications for patients taking these medications. It is critical to support the health and nutrition profile before and following dental implant procedures to assist patients who are often dealing with other diagnoses compromising their health.

My years of working with nutraceuticals have led me to look at what our patients can do to protect themselves from pharmaceuticals that cause drug nutrition depletion issues or known side effects that may respond to a nutritional supplementation program. In this particular scenario concerning bone health, we should be investigating the value of supporting our patients with Vitamin D3 and minerals, especially magnesium.

Research indicates relevance of Vitamin D levels in the dental practice and a deficiency of Vitamin D as a causative factor in the failure of dental implants. (1) Vitamin D deficiency may play a role in the failure of osseointegration in dental implants. (2) In addition, Vitamin D is a key factor for linking innate and adaptive immunity and under the conditions of Vitamin D deficiency may also increase the risk for graft infections. (3)

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Minerals such as calcium and magnesium are important for general health, growth, and repair of cells and tissues. Adequate intake of a balanced mineral formulation along with Vitamin D may aid in skeletal bone density as well as periodontal health to increase the chances for dental implant success. (2)

Additional research is needed, but several small studies also report a correlation with low serum Vitamin D and symptoms of depression. Magnesium is an important mineral and cofactor that impacts hundreds of metabolic reactions in the body. Researchers have found that magnesium deficiency is associated with increased symptoms of depression and that magnesium supplementation has been shown to improve depression. (4)

These links between antidepressant medications and dental implant failure and the importance of Vitamin D and magnesium in the management of symptoms associated with depression make it especially important to address the Vitamin D levels and magnesium intake of patients before implant surgery.

References
1. Martelli FS, Martelli M, Rosati C, Fanti E. Vitamin D: relevance in dental practice. Clin Cases Miner Bone Metab. 2014;11(1):15-9.
2. Bryce G, MacBeth N. Vitamin D deficiency as a suspected causative factor in the failure of an immediately placed dental implant: a case report. J R Nav Med Serv. 2014;100(3):328-32.
3. Choukroun J, Khoury G, Khoury F, Russe P, Testori T, Komiyama Y, et al. Two neglected biologic risk factors in bone grafting and implantology: high low-density lipoprotein cholesterol and low serum Vitamin D. J Oral Implantol. 2014;40(1):110-4. doi: 10.1563/AAID-JOI-D-13-00062. Epub 2013 Oct 9.
4. Tarleton EK, Littenberg B. Magnesium intake and depression in adults. J Am Board Fam Med. 2015;28(2):249-256.

Kevin Oberlander, RPh, owns and operates Dakota Pharmacy and has an interest in Dakota Serenity Nutrition.

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