SSRI usage associated with tooth and restoration fracture via bruxism and other movement disorders: could mouthguards protect the teeth of SSRI users? [poster]
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Background: The association between movement disorders and tooth or restoration fractures has been described by dental literature. Conversely, medical literature has discussed the development of movement disorders in patients taking selective serotonin reuptake inhibitors (SSRIs). The aim of this study was to determine whether there is an association between taking SSRIs and the increased incidence of tooth or restoration fracture as mediated by movement disorders. This study further investigates whether mouthguards may act as a moderator of the model. Methods: A retrospective study was performed regarding individuals who had prescription coverage and at least one dental encounter between 2008 and 2012. Exclusion of research opt outs, minors and adults over the age of 85 yielded a cohort of 105,949 individuals. Results: Within our cohort, 19.6% of the population took SSRIs at some point between 2008 and 2012. Based on pvalues and odds ratios from mediation analysis, movement disorders including bruxism, clenching and temporomandibular muscle disorders (TMDs) of the muscle and joint were positively and significantly associated with SSRIs and the increased prevalence of tooth or restoration fractures when controlling for age, gender and depression. Tests of the protective nature of a mouthguard proved inconclusive, possibly due to the small sample size of mouthguard users. Conclusions: A positive and significant association exists between SSRIs and the increased prevalence of tooth or restoration fracture as based on the mediation of movement disorders. Implications suggest fostering more attune monitoring practices among dentists for the development of movement disorders and subsequent fractures in patients taking SSRIs.