Impact of Commonly Prescribed Antidepressants on Salivary Flow Rate and Oral Health Status

Antidepressant medications are widely prescribed for the management of depressive and anxiety disorders. While their systemic effects are well documented, their influence on salivary gland function and oral health remains under-recognized. Reduced salivary flow can predispose patients to dental caries, periodontal disease, and impaired oral quality of life.

A cross-sectional comparative study was conducted among 120 participants aged 20-55 years, divided into three groups: Selective serotonin reuptake inhibitors (SSRIs; n = 40), tricyclic antidepressants (TCAs; n = 40), and healthy controls (n = 40). Unstimulated salivary flow rate was measured using the spitting method. Oral health status was assessed using the Decayed, Missing, and Filled Teeth (DMFT) index, Plaque Index (PI), and Gingival Index (GI). Statistical analysis included one-way ANOVA and post-hoc Tukey tests, with significance set at P < 0.05.

Mean unstimulated salivary flow rate was significantly lower in the TCA group (0.21 ± 0.07 mL/min) compared to the SSRI group (0.32 ± 0.09 mL/min) and controls (0.46 ± 0.11 mL/min) (P < 0.001). The TCA group demonstrated significantly higher DMFT scores (6.1 ± 2.3) than the SSRI (4.3 ± 1.9) and control groups (2.6 ± 1.4) (P < 0.001). Plaque and gingival scores were also significantly elevated among antidepressant users.

Antidepressant therapy, particularly TCAs, is associated with reduced salivary flow and compromised oral health. Early dental monitoring and preventive strategies are essential for patients receiving long-term antidepressant therapy.