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Why You Might Get a Prescription From Your Dentist

When it comes to dealing with both medical and cosmetic dental problems, we can turn to a wide variety of over-the-counter products to solve some of our most common oral annoyances. But will whitening strips purchased at the drug store or braces ordered online actually work? 

The answer can be yes, for some people in some cases. But for others, the only way to effectively treat a dental problem is with a prescription from the dentist. 

Here are some common dental prescriptions and situations when your dentist might suggest them.


Toothpaste

For many people, over-the-counter toothpastes are sufficient for preventing cavities and providing fresh breath. 

Prescription toothpastes, on the other hand, contain a higher concentration of fluoride than drugstore varieties. Dentists may prescribe these for people at higher risk of cavities due to genetics or health conditions. People with inflammatory bowel disease, for example, often have more bacteria in their mouths that causes tooth decay, and children with congestive heart disease may have weakened enamel due to poor oxygenation, says Dr. Lorna Flamer-Caldera, a dentist in New York and a spokesperson for the Academy of General Dentistry

“Prescription toothpaste can keep cavities-in-progress from getting worse and dramatically reduce the risk of new ones,” she says. 

However, just because you’re using a powerful anti-cavity toothpaste doesn’t mean you can let your oral hygiene habits slip. Dr. Yenile Pinto, a dentist in Palmetto Bay, Fla., often suggests her cavity-prone patients partake in nutritional counseling. 

“If you’re sipping on sugary soda all day, prescription toothpaste isn’t going to solve the problem on its own,” she says. 


Whiteners

If you’re in your 20s and you want to whiten your teeth, the whitening strips you buy at the pharmacy will likely do the job. 

“If you’re a couple of decades beyond that and you’re a tobacco user or a heavy coffee drinker, you will have staining that’s built up in the enamel layer, and a strip probably won’t have a noticeable effect,” Flamer-Caldera says.

Your dentist may suggest prescription tooth whitening, either as a one-time treatment in the office or at home with a series of trays that you use over time. At-home treatments are less costly and a better option for people with sensitive teeth because the active ingredient is less concentrated, Flamer-Caldera says.


Mouth rinses

Prescription mouthwashes, known as “therapeutic” mouth rinses, contain ingredients to address conditions such as gingivitis, thrush, dry mouth and bad breath. 

There are OTC versions of therapeutic mouthwashes, but they may not be enough to resolve your problem. (“Cosmetic” mouthwashes found in the drugstore merely cover bad breath with a minty scent.)

Your dentist may prescribe a therapeutic rinse if you come in with symptoms of the aforementioned conditions. Mouth rinses containing the active ingredient chlorhexidine, used to treat gingivitis, for example, are available only by prescription. 


Dry mouth treatments

Dry mouth, or xerostomia, is a condition in which the mouth does not produce enough saliva. It has a number of possible causes, including menopause and cancer treatments, or it can be a side effect of some medications. 

Saliva is important to oral health because it keeps food from sticking to the surfaces of your teeth and maintains the proper pH of the teeth — both keys to preventing cavities. 

“If you have dry mouth, your risk of decay goes way up,” Flamer-Caldera says. 

Prescription medications to treat xerostomia can moisturize the mouth and stimulate saliva production. These prescriptions may come in the form of a mouth rinse, gel or pill.


Teeth straighteners

You don’t have to embrace the metal mouth look anymore if you want to spruce up your smile. Instead, you can opt for removable aligner therapy, in which you wear a sequence of removable clear trays custom made for your mouth. 

There are versions that you can order online, but Pinto warns against using them unless you’ve consulted with your dentist; if you have dental implants or crowns, OTC straighteners can damage them.

Aligner therapy can be offered by any dentist certified to provide it, including orthodontists. You’ll start by going in for a pre-treatment assessment. Then your doctor will take molds of your teeth and send them to a lab, where the aligners are made. 

The timeline for how long you’ll wear aligners depends on your specific needs and goals; in most cases, you’ll need to wear a retainer at night after finishing treatment to maintain your newly-straightened smile.


Night guards

For bruxism, also known as teeth grinding, wearing a mouthguard while you sleep can prevent significant wear and tear on the teeth. 

There are numerous potential causes of bruxism, including stress and anxiety, a misaligned bite, alcohol and tobacco use, and temporomandibular joint (TMJ) disorder. No matter the underlying cause (which may need to be addressed on its own), the result is worn down teeth. In some cases, grinding can even lead to fractured and loosened teeth. 

Flamer-Caldera says OTC mouth guards — the ones you boil and then bite to mold to your mouth — are OK for short-term use to relieve acute pain. But, as with aligners, the OTC versions can’t compete with a custom-made product. 

For the long haul, Flamer-Caldera recommends a prescription guard made in a laboratory under the specifications of a dentist. “They’re a completely different animal than what you buy over the counter,” she says. 


Before you take the plunge on any product or treatment, keep in mind that dental insurance may cover therapeutic treatments like dry mouth medications, but cosmetic treatments aren’t always covered; be sure to check with your insurance provider. When in doubt, talk to your dentist for guidance. 

“There are a lot of over-the-counter products that are perfectly good,” Pinto says. “You just need to know if they’re going to work for your needs.”


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