Dental implants can be affected by medications. SSRIs, which is an abbreviation for Selective Serotonin Reuptake Inhibitors, are a common medication class which can affect dental implants. Examples of SSRIs include:

• Prozac
• Zoloft
• Lexapro
• Celexa

They are used for conditions such as:

• Depression
• Anxiety
• Panic attacks
• OCD (Obsessive Compulsive Disorder).

In fact, in a list of the top 100 drugs, 5 of them are SSRIs. This is why its important to understand their relationship to dental implants if you are considering dental implant therapy to restore an oral condition, and you take one of these SSRIs.

Serotonin is a chemical made by the body for communication between cells. It is released by cells, and then reabsorbed (known as reuptake). The SSRI blocks the reuptake. How it actually helps patients with depression, anxiety, panic attacks, or OCD is unknown, but like most medications, there are side effects that can affect one’s health, including dental implants.

In 2014 there was a study done on SSRIs and dental implants. What was interesting with this study was that dental implant failures were about double when compared to patients who didn’t take SSRIs. But these failures were what we call “late failures,” which means the implants did not fail when they were placed or while they were healing, but rather when the implants were “loaded,” or placed into function.

But this isn’t all of the important information. Its important to know that serotonin is integral during the loading phase of dental implants. The problem is with the EXCESS serotonin that is present due to the SSRIs. Just like the fact that we don’t know exactly how SSRIs help with depression, anxiety, panic attacks, or OCD, we don’t know exactly how this excess serotonin causes the late-stage implant failures. There is a hypothesis that the bone mass loss is caused by the SSRI interfering with the regular bone healing process when the implants are loaded.

So what does all this mean to you as a consumer if you take an SSRI and are searching for an implant dentist to treat you for your dental implants? Here are some points to consider:

• If you have implants placed and restored, and at some point down the road you develop problems, it might be due to your medication.
• Even though you might want to get your dental implants finished right away, your dentist might suggest a longer healing time.
• If you have to have multiple implants placed side-by-side, your dentist might suggest they be “splinted,” meaning they may be connected to each other. This helps to strengthen them.
• Your dentist might also suggest the implants have temporary crowns placed before the final crowns are fabricated: this may cause your treatment time to be longer and the overall implant cost be higher, but your dentist is looking out for your best interest.

As mentioned above, what is known about the inter-relationship between dental implants and SSRIs is relatively new. Questions that have been posed, and not yet answered, include:

• Does the type of SSRI matter? What effect will one SSRI have on a dental implant as opposed to another?
• Does the dosage of the SSRI matter? What effect will the drug strength have on dental implants?

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Dr. Ira Goldberg is a Diplomate of the American Board of Oral Implantology / Implant Dentistry, a Diplomat of the International Congress of Oral Implantologists, a Fellow of the American Academy of Implant Dentistry, and the Vice-President of the Northeast District of the American Academy of Implant Dentistry. He has been practicing implant dentistry for over 20 years and teaches implant dentistry to other dentists. He is a general dentist and owner of Morris County Dental Associates, LLC in the Roxbury Mall in Succasunna. Additional information can be found on his website: www.MorrisDountyDentist.com. The office can be reached at: (973) 328-1225 or via email: frontdesk.mcda@gmail.com