Antibiotics and Mouthwashes Sometimes Leave Colorful Reminders of Their Use

If you have deep-seated gingivitis, chances are that simply going to the dentist for a cleaning is not going to be enough. You are likely to be prescribed one or more germ-fighting medications to keep the bacteria that cause gum infections from coming back.

These medications can help save your teeth, but if you don’t use them properly, many cause their own cosmetic problems. Here is what you need to know about the potential side effects and limitations (and some unexpected benefits) of the most common gingivitis medications.

Acetaminophen with codeine (Tylenol #3) usually does not cause any side effects, but it can induce severe nausea, vomiting, and constipation in people who are sensitive to codeine. The constipation is replaced by diarrhea when the drug is discontinued.

Chlorhexidine mouthwashes such as prescription Periguard and Periodex won’t work if you use them right after you brush your teeth. Some of the ingredients in toothpaste can deactivate the chlorhexidine. It’s best to wait at least 30 minutes and preferably 2 hours after brushing before you use the mouthwash. Also, chlorhexidine can bind to the tannins in coffee, tea, and red wine (as well as many herbal teas) to form permanent stains on your teeth.

Doxycycline (Periostat) counteracts birth control pills, increasing chances of pregnancy in women who use both doxycycline and oral contraception.

Erythromycin (EES, Ery-Tab, Erythrocin) is often recommended for people who have gingivitis and who are allergic to penicillin. If you use an asthma inhaler, however, your body will have difficulty clearing the antibiotic out of your system.

Fluoride toothpastes inhibit acid-loving bacteria, but simply brushing your teeth or at least rinsing out your mouth after eating carbohydrate foods and sweets has the same effect.

Ibuprofen (Ibuprin, Advil, Motrin) should be used with caution by people who have asthma.

Listerine mouthwash fights gingivitis germs but Listerine gel packs do not.

Minocycline microspheres (Arestin) can cause a condition called “blue smile” by staining the gums, but this usually only occurs when it is given to children under the age of eight or to women in the second or third trimester of pregnancy. It can also make a yeast infection worse.

Toothpastes made with stannous fluoride don’t remove plaque, although they kill some of the bacteria that cause plaque. They may help keep gingivitis from getting worse, but they won’t make gum tissue loss any better.

Xylitol-sweetened sugar free chewing gum won’t feed the bacteria that cause gingivitis, and helps fight the bacteria that cause ear infections, especially in children.