Aripiprazole

Oral health effects

• Xerostomia (dry mouth)

  Reduced salivary flow raising caries, candidiasis, and mucosal discomfort risk.

  Clinical management: Hydration, sugar-free gum/xylitol, salivary substitutes, high-fluoride products; reinforce caries prevention.

• Dizziness on standing (orthostatic hypotension)

  Orthostatic hypotension is a label warning, though uncommon (about 1% vs 0.3% on placebo in adults).

  Clinical management: Raise the chair slowly at the end of the appointment and have the patient sit upright for a minute or two before standing; steady them as they get up. Ask about dizziness on standing, especially after dose changes or in older patients.

• Tardive dyskinesia (orofacial movements, lower risk)

  Long-term use can cause potentially irreversible involuntary movements of the tongue, lips and jaw (label warning). The risk is lower than with older antipsychotics but not zero.

  Clinical management: Look for involuntary tongue, lip or jaw movements; they can make instrumentation, impressions and denture retention difficult. Use short appointments, bite blocks and good support, and report new or worsening movements to the prescriber, as early detection matters.

• Excess saliva / drooling (sialorrhea)

  Salivary hypersecretion was reported in 4% of adults on adjunctive bipolar treatment (vs 2% on placebo) and 6% of adolescents with bipolar mania (vs 0%); drooling occurred in 9% of children treated for irritability with autism.

  Clinical management: Ask about drooling or excess saliva; it may cause angular cheilitis and skin irritation. Use high-volume suction and frequent breaks during care, and check the commissures for cheilitis or candidiasis.