Dental Drugs and Medications

What are dental drugs and medications?

Dentists use a range of dental medications to treat health conditions that affect your mouth. You may receive medication to manage pain, help you relax, prevent disease or fight infection.

Your dentist will recommend dental medications and dosages based on your needs, age, medical conditions, current medications, weight and other factors.

What are the types of dental drugs and medications?

Several types of medications are used in dentistry, depending on your needs. Your dentist may give them to you in the office as part of a treatment or procedure, or you may need to take a prescription to the pharmacy and take the medications at home. These include:

• Pain relievers (analgesics) or numbing medications.
• Preventive medications to prevent tooth decay or manage plaque and gingivitis.
• Medications to treat dry mouth or excessive drooling.
• Antibiotics.
• Antivirals.
• Antifungals.
• Sedatives.
• Anti-anxiety medications (anxiolytics).

Medications you might get at the dentist’s office

During nearly every dental appointment — from cleaning, to cavity fillings, to root canals and more — your dentist will use some type of medication as part of your treatment. These may include:

Medication for pain relief or sedation during dental procedures

Dentists use anesthesia to soothe pain or irritation by numbing irritated parts of your mouth so you don’t feel anything. Like pain medications, the calming effect of anesthetics can also help prevent discomfort or anxiety.

Over-the-counter (OTC) or prescription anesthetics come in many forms, including gels and sprays. You can also receive an injection or inhale an anesthetic. The main types used in dentistry are:

• Topical anesthetic, including benzocaine, which can be applied directly to the inside of your mouth.
• Local anesthetic, like lidocaine or novocaine, which numbs a specific part of your mouth — during wisdom teeth removal, for instance.
• General anesthesia, which relaxes your whole body and puts you to sleep.

Sometimes, your dentist uses a sedative, so you can rest in a light sleep but respond to your care team when needed. Or they may give you nitrous oxide (laughing gas) to help you relax during a procedure. If you have high blood pressure (hypertension), your dentist may combine epinephrine with local anesthesia. This reduces bleeding during your treatment.

Medication to prevent tooth decay

Tooth decay (cavities) occurs when acid wears away the surface of your teeth (tooth enamel). Dentists often recommend fluoride to strengthen teeth and prevent or reverse tooth decay. Talk to your provider about the most effective form of fluoride for your needs.

Medication to manage plaque and gingivitis

Dental plaque is a common problem that people develop. Untreated, it can lead to early-stage gum disease (gingivitis) or bad breath.

To remove plaque and prevent or treat gingivitis, dentists often use an antiseptic drug called chlorhexidine (like Peridex™). You use chlorhexidine as a mouth rinse to reduce bacteria from periodontal disease (gum disease) or after a dental procedure (usually for a short time).

Chlorhexidine use may lead to increased tartar buildup on your teeth or stain your teeth, fillings, dentures or other appliances. It can also affect your sense of taste. Keep follow-up appointments to treat buildup and stains, and to help maintain good oral hygiene.

At-home medications for dental conditions

You may need other medications that you take at home, either before or after your visit with the dentist.

Medication for dental pain

You may experience pain, irritation or discomfort with dental appliances like dentures or braces, or conditions like toothache or canker sores. Topical analgesics (like Anbesol®, Chloraseptic®, Orajel® and Xylocaine®) that you rub inside your mouth can relieve the pain. Ask your dentist before using one of these medications. However, never use topical analgesics for teething in infants.

These analgesics come in several forms:

• Cream or dental paste.
• Gel.
• Lozenge.
• Mouth rinse.
• Ointment.
• Spray.

You may also need pain management before having dental work. Your dentist may recommend over-the-counter or prescription pain relievers before cavity filling, crown placement (restorative dentistry) or oral surgery.

These drugs include:

• Acetaminophen.
• Corticosteroids.
• Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, aspirin and naproxen, for mild to moderate pain. (Never give aspirin to infants and children unless directed by your dentist.)
• Opioids (narcotics) for moderate or severe pain from procedures such as tooth extraction (removal), gum graft surgery or dental implants.

Talk to your dentist about the potential side effects of pain medications, like dry mouth (xerostomia), dental plaque or cavities. Many over-the-counter pain relievers are equally effective — or more effective — than opioids, which carry significantly more risk. 

Medications for dry mouth or drooling

Dry mouth develops when the glands in your mouth (salivary glands) don’t make enough saliva (spit). Dental medications to increase saliva production (sialagogues) include:

• Cevimeline.
• Pilocarpine.
• Saliva substitutes, with ingredients that temporarily relieve dry mouth symptoms.

Some people have too much saliva (hypersalivation). Your dentist can use medications to reduce how much saliva your glands make (antisialagogues). Drugs to reduce drooling or hypersalivation include:

• Atropine sulfate.
• Glycopyrrolate.
• Scopolamine.

Medications for severe gum disease

In cases of severe gum disease (periodontitis), your dentist may recommend antibiotics like amoxicillin or doxycycline. These medications fight bacterial infections and help prevent the loss of gum tissue or bone and other complications.

Antibiotics for oral bacterial infections

Dentists use a range of antibiotics to treat oral infections caused by bacteria. They come in many forms, including mouth rinses, ointments, tablets or liquids. 

In some cases — like severe gum disease (periodontitis) — you may receive an antibiotic before or after dental care. This prevents bacteria normally found on tissues around your teeth from entering your blood, where they can cause infection in another part of your body.

Common antibiotics used in dentistry include:

• Amoxicillin
• Clindamycin
• Azithromycin.

Your treatment may involve only an antibiotic or an antibiotic combined with other medications or therapies. 

Antivirals for oral viral infections

While other providers may care for you when you have a cold or flu, dentists often treat viruses that affect your mouth. Medications can’t cure viral infections, but they can reduce symptoms like cold sores.

Antiviral drugs used in dentistry include:

• Acyclovir.
• Valacyclovir.
• Famciclovir.

Antifungals for oral fungal infections

Thrush is a common oral infection caused by a fungus called Candida albicans. To stop it from spreading, your dentist uses antifungal medication. Dentists also prescribe antifungal medication to treat denture stomatitis.

You may receive these drugs in lozenge or tablet form. Or you may “swish” liquid medication in your mouth before spitting it out or swallowing it. Common types are:

• Clotrimazole.
• Fluconazole.
• Miconazole.
• Nystatin.

Medication for dental anxiety

Many people feel a bit anxious at the thought of going to the dentist. But if your dental anxiety starts to interfere with your day-to-day life, talk to your dentist. They may recommend ways to reduce your stress and relax your muscles. They may also suggest talking with a mental healthcare provider about medications to reduce anxiety and/or depression.

Anxiety disorders can affect your mouth in lots of ways. They may:

• Cause you to grind your teeth a lot (bruxism).
• Contribute to temporomandibular joint (TMJ) disorders. Occasionally, dentists may prescribe muscle relaxers to help manage TMJ.
• Affect your dental hygiene if you have a hard time doing daily activities like brushing your teeth.

What are the benefits of medications in dentistry?

Your dentist uses medications to keep you safe, comfortable and healthy. Each type offers its own benefit.

Some medications fight infection or make procedures easier. Others keep your teeth and gums healthy or relieve pain. Ask your dentist about the medications you may need and any questions you may have.

What are the risks? 

Most medications used in dentistry are low-risk. In some cases, medications treat one condition but may raise your risk of another.

For example, some strong pain medications can make it more likely that you develop cavities or dry mouth. Your dentist will discuss the risks and benefits of each type of medication and work with you to prevent complications.

A note from Cleveland Clinic

Dentists use medications to provide safe and effective care for issues involving your mouth, teeth or gums. Medications can manage pain, ease your anxiety before a procedure, clear up infections or prevent complications. Your dentist will discuss what medications you need, how they work and how you can expect to feel. They can also answer your questions, so you feel comfortable and reassured about your dental care.