There is an increased likelihood of advanced periodontal disease in patients on long-term immunosuppressive medication.1 Many patients also suffer from profound salivary hypofunction related to these drugs.2

The long-term care of these patients' dentition requires excellent oral hygiene measures, often including adjunctive agents, such as topical fluoride application. Regular dental reviews, professional vigilance and a strong emphasis on preventive dentistry are necessary for the stability of these patients' dental health. They may also often be taking other medicines, such as bisphosphonates, so dentists need to take time to undertake a thorough review of each patient's medical history and continually check which drugs are being used. For patients taking corticosteroids who require invasive procedures such as dental extractions, increasing the dose is recommended to minimise the risk of adrenal crisis.


  1. Page RC, Beck JD. Risk assessment for periodontal diseases. Int Dent J 1997;47:61-87.
  2. Guggenheimer J, Moore PA. Xerostomia: etiology, recognition and treatment. J Am Dent Assoc 2003;134:61-9.