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Yikes! SSRI’s (selective serotonin re uptake inhibitors, or antidepressants) are linked with dental implant failure in a recent retrospective study out of McGill University in Canada, published in the Journal of Dental Research. (Reference below)

The authors suggest that SSRI’s might cause bone mass loss by inhibiting bone-remodeling processes triggered by mechanical loading. “SSRIs block
5-HTTs on bone cells, resulting in a direct negative effect in bone formation
(Diem et al., 2007; Yadav et al., 2008) and metabolism (Tsapakis et al., 2012)
by increasing osteoclast differentiations (Battaglino et al., 2004) and inhibiting
osteoblast proliferation (Tsapakis et al., 2012). As a result, SSRIs decrease
bone mass and bone mineral density (Battaglino et al., 2004; Diem et al.)”

When a patient comes into my office  for an examination, I look at the medications they take, and put them into a pharmacology program* that gives me information regarding what the medications are for, what dental issues or side effects are of concern, and then what if any interactions they might cause with any medications I might prescribe. One of the issues that arises often with SSRI’s is bruxism. The authors do not mention that in their study, but I wonder if that didn’t contribute to the failures seen.

Does this mean if you’re depressed you cannot have a dental implant? I think more study needs to be done. Consideration should be given though, to a longer healing time for implants in these patients, and to not immediately loading the implants (i.e. no ‘teeth in an hour’). A bruxism appliance following implant restoration might also be warranted.

The authors also mentioned smoking!!! There remains a higher failure rate of implants in smokers. One more reason to quit. Today.

Keep flossing!

DrB

Selective Serotonin Reuptake Inhibitors and the Risk of Osseointegrated Implant Failure: A Cohort Study. X. Wu, K. Al-Abedalla, E. Rastikerdar, S. Abi Nader, N.G. Daniel, B. Nicolau and F. Tamimi.  J DENT RES published online 3 September 2014. DOI: 10.1177/0022034514549378.   The online version of this article can be found at:  http://jdr.sagepub.com/content/early/2014/08/26/0022034514549378

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#dental implants #antidepressants #SSRI’s #implant failure #bruxism #Lexicomp