Family and Caregiver Schizophrenia Discussion Forum

Constant dental problems due to meds/dry mouth

I’m new here, so Hello to everyone!

I’m the parent of a 23-yr old son with schizoaffective disorder, childhood onset. For several years, he has been stable on meds (mainly clozapine). Such a relief! He still lives in the family home and I am his caregiver so I’m aware of his eating, drinking, and dental care habits. Despite good dental hygiene and a pretty good diet (no sodas or sweet drinks, prescription fluoride toothpaste to try to prevent cavities, etc), he has a mouthful of cavities and will need approximately $3000 of dental repair – again! (This is not the first time.) The dentist thinks his teeth are deteriorating because of “dry mouth” (from medications), which allows germs to thrive on teeth and gums.

My son has just started using Biotene to help alleviate the feeling of dry mouth. But I doubt that stuff will prevent germs from growing and rotting his teeth. My son does not drink alcohol or use any drugs other than prescribed for his schizoaffective disorder, and does not smoke. But his teeth are rotting away.

Clozapine is the best thing in the world for my son’s mental health and I don’t want him to stop taking it. But it can interfere with immune system function. I wonder whether that’s part of the reason why germs & decay are running amok in his mouth.

Has anyone else out there dealt with constant dental problems? Any solutions found?

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@ NeverTooLate, Thank you for sharing your experience and your suggestion. I hadn’t thought of gum. Worth trying!

My son is on clozapine and also and started out with a lot of dental problems, he has some kind of drink with him all the time. I had my son’s vitamin levels tested, especially D and he was very low. The 2000 units a day over the counter dosages did nothing to raise his level so the doctor prescribed 1- (50,000 unit) capsule of D3, per week and he’s been on that for a couple of years (we tried D2 at first and it was useless) and his D level stays normal and steady now and his dental exams have been perfect, no cavities. I read that vitamin D helps with calcium absorption and when it’s lacking it can cause dental issues. From what I’m seeing I think that’s true.

Welcome okra! This community is a great resource for questions like yours:)

Catherine, that is very helpful info. My son has been taking D3 2000 IU (over the counter) daily for about 2 years. His latest lab test came back “normal” so I had not thought of vit D being a problem. But your son’s story is an eye opener. I didn’t know there is such a thing as a prescription, long-acting vit D3 capsule. I can ask my son’s doctor about that. Thank you!

Btw, my son has been hypothyroid since sometime in early childhood. Before his hypothyroidism was diagnosed, he developed lots of cavities in his baby teeth. He wasn’t growing normally and his hair was barely growing at all. When he began taking levothyroxine daily (almost age 6), his teeth improved a lot. His body and hair began growing normally. His dosage rose as he grew older, but has held steady at 112 mcg since mid-teens. With that dosage, lab results always come back in normal range. But when cavities are destroying his teeth, I start wondering whether the lab test is wrong.

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Thank you, Hope. Glad to be here.

My son gets new labs for most things every six months other than his blood draw for clozapine which is every month. Things can change at the drop of a hat it seems. I wish you and your son the very best.

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Not sure if this would help, but when I was going through chemotherapy, I used Biotine during my treatment. It really did help.

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Holly, thank you. My son has just started trying Biotene. No word yet on whether it’s helping him. Glad to know you found it helpful. Maybe it will work for my son, too.

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Catherine, I just wanted to send you an update. It’s been a little over a month since I first posted this topic. I did contact my son’s endocrinologist about Vitamin D and thyroid levels. But the doctor decided not to re-check his bloodwork since it has only been about 6 months from his last endocrinology labwork. He checks those levels annually. He did not feel like a re-check is warranted so soon and he did not recommend raising my son’s D3 dosage without a blood test. I’m following his recommendation for now, but if cavities continue to happen, I’ll contact the doctor again. If necessary, my son could get his Vit D level checked at a place that offers lab tests on request without doctor’s prescription.

I hope your son is doing well. Thanks for you helpful tip about Vit D.

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Thanks so much for the update. My son is doing well (as can be). If you get the opportunity —maybe talk to a dentist about your son’s teeth, sometimes they can offer insight a doctor may not. I found out from my son’s dentist that 6 of his teeth are still baby teeth and there are no adult teeth behind them to grow in if they are lost (actually he has already lost 3 as of now) Still his other teeth seem to be doing pretty well which shocks me because he only brushes once a day and occasionally he will go on a candy binge. I went to all the trouble of getting him fitted for a partial only to have him adamantly refuse ro wear it after the 2nd day home with it. So frustrating but not surprising. I wish you and your son all the best.

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Second that!! Dry mouth is a growing concern in the dental field. The office I work in recommends it a lot for dry mouth–whatever the cause.


Ask about Periodex or a tooth and gum tonic. Some people just are more genetically prone to decay. Also as silly as this sounds, swishing with water after eating breaks up the activity of the "sugar bugs. Investing in a waterpik may not be a bad idea. Finally, when you say no sweet drinks you also are talking about energy drinks or poweraid/gateraid right?

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Thanks for your advice, especially since you work in a dental office. “Sweet drinks” – my son stopped drinking gatorade, iced tea, soft drinks, etc a few years ago when he had a mouthful of cavities that required extensive dental work. Since then, he drinks only water, except for a very rare smoothie.

@ okra Yesterday a rep was in and they are releasing new products to deal with dry mouth. It is becoming almost common place. And with so many people drinking bottled water and forgoing fluoride (I have heard both sides)there is a growing increase in caries–all ages. Next visit talk to doc or assistant about the products available. Most likely they will have samples. If he will use them that is great! My son is somewhat suspicious of anything new. Ok, really a lot suspicious but does brush regularly and will rinse with water.

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