Polypharmacy-induced changes in the oral mucosa and jawbone in elderly

Polypharmacy is increasingly prevalent among the elderly due to the higher incidence of chronic diseases. The oral cavity undergoes age-related changes, including cellular aging and immunosenescence. Thus, susceptibility to oral discomfort increases in the elderly, and decreased salivary secretion, ulceration, burning sensations, and other oral symptoms can be seen. The oral mucosa is particularly vulnerable to conditions such as xerostomia, mucositis, and oral candidiasis, exacerbated by medications that impact salivary gland function and immune response. Key pharmacological agents implicated in these effects include antihypertensives, antidiabetics, bisphosphonates, and immunosuppressants. Although these medications are essential for the overall health of the patient, the long-term effects of polypharmacy on the oral cavity cannot be overlooked. Their impact on oral health necessitates careful consideration. A comprehensive understanding of oral changes is essential for developing strategies to mitigate the adverse effects of polypharmacy and improve oral health outcomes in the elderly. This chapter synthesizes existing research to identify causative agents and summarizes preventive measures, diagnostic criteria, and treatment strategies related to polypharmacy-induced oral mucosa and jawbone alterations. Furthermore, it outlines current research findings and provides recommendations for clinical practice, highlighting the importance of interdisciplinary collaboration in managing the oral health of elderly patients with complex medication regimens.