Reduced salivary flow induced by systemic isotretinoin may lead to dental decay. A prospective clinical study.
BACKGROUND
The adverse effects of isotretinoin have been well documented, but dental side effects over the course of treatment have never been studied.


OBJECTIVE
To prospectively document the oral side effects experienced by a group of patients taking isotretinoin and to compare the changes in oral health and salivary parameters with a control group.


METHODS
A cohort study was conducted within the dermatology department at the University Hospital in collaboration with two private dermatology practices in Nice, France. Patients were treated at a dose of 0.5 mg/kg/day. The control group was made up of students from the University of Nice-Sophia-Antipolis. The salivary flow, the buffer capacity of saliva, the number of pathogen bacteria and the DMFT index (number of decayed, missing and filled teeth) were assessed at each visit.


RESULTS
Eighteen patients and 99 controls were available for evaluation. None of the oral parameters varied with time in the control group, whereas the DMFT significantly increased in the treated group (3.07 +/- 3.85 vs. 3.41 +/- 4.36; p<0.036). The salivary flow gradually decreased with time (p<0.004), but the patients recovered their baseline salivary flow 2 months after the end of the treatment.


CONCLUSIONS
This study clearly showed that patients treated with isotretinoin experienced oral side effects.
Lupi-Pégurier
L
L
Department of Dentistry, Centre Hospitalier Universitaire de Nice, UNSA, Nice, France. lupi@unice.fr
Muller-Bolla
M
M
Fontas
E
E
Ortonne
J P
JP
D000293:Adolescent; D000328:Adult; D003731:Dental Caries / Q000209:etiology*; D003879:Dermatologic Agents / Q000009:adverse effects*; D005260:Female; D006801:Humans; D015474:Isotretinoin / Q000009:adverse effects*; D008297:Male; D011446:Prospective Studies; D012472:Salivation / Q000187:drug effects*
D003879:Dermatologic Agents; D015474:Isotretinoin