Clinical decision-support only. For use by licensed dental professionals. Not a substitute for professional judgment or a complete drug reference. Always verify with primary sources.
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Medication

Citalopram

Antidepressant (SSRI)

Brand names: Celexa

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.

  • Bruxism (possible)

    Case reports link SSRIs to new or worsened clenching and grinding, but a 2018 systematic review found no increased risk of sleep bruxism for sertraline, fluoxetine, citalopram or escitalopram. Evidence is low certainty.

    Clinical management: Assess for wear; consider an occlusal guard; discuss with prescriber if severe.

  • Increased bleeding tendency (impaired platelet function)

    Drugs that block serotonin reuptake reduce platelet serotonin and can increase bleeding (FDA label warning), especially when combined with aspirin, NSAIDs or anticoagulants. Dental studies suggest clinically significant oral bleeding is uncommon.

    Clinical management: No need to stop the antidepressant before scaling or root planing. Expect possible extra gingival bleeding; use local measures (pressure, hemostatic agents) and ask about aspirin, NSAIDs or anticoagulants, which add to the risk. Prefer acetaminophen over NSAIDs when suggesting post-procedure analgesia.

  • Taste disturbance (dysgeusia)

    Altered taste is listed as a frequent adverse reaction ("taste perversion") in the FDA label.

    Clinical management: Ask about altered or metallic taste, which can reduce appetite and oral comfort; reassure that it is drug-related and often fades. Rule out oral candidiasis or poor hygiene as contributors and encourage sugar-free options rather than sweet foods/drinks used to mask the taste.

Sources

  1. A Guide to Medications Inducing Salivary Gland Dysfunction, Xerostomia, and Subjective Sialorrhea: A Systematic Review Sponsored by the World Workshop on Oral Medicine VI. Wolff A, Joshi RK, Ekström J, et al. Drugs in R&D, 2017.
  2. Adverse drug events in the oral cavity. Yuan A, Woo SB. Oral surgery, oral medicine, oral pathology and oral radiology, 2015.
  3. Association between psychotropic medications and presence of sleep bruxism: A systematic review. Melo G, Dutra KL, Rodrigues Filho R, et al. Journal of oral rehabilitation, 2018.
  4. Citalopram prescribing information (FDA label) A-S Medication Solutions / DailyMed, 2024.
  5. Risk of gastrointestinal bleeding by specific SSRIs and SNRIs: A systematic review and meta-analysis. Gomez-Lumbreras A, Tawfik AG, Del Fiol G, et al. British journal of clinical pharmacology, 2026.
  6. Systematic Review on Antidepressant Use and Bleeding Risk After Dental Extractions: Evidence Gaps and Clinical Implications. Nemeth A, Rahimi K, Karande S, et al. Journal of clinical medicine, 2025.
  7. Oral Manifestations in Patients in Treatment with Antidepressants: A Systematic Review. Alcázar-Hernández JM, Pecci-Lloret MR, Guerrero-Gironés J. Journal of clinical medicine, 2024.
  8. A review and guide to drug-associated oral adverse effects-Dental, salivary and neurosensory reactions. Part 1. Teoh L, Moses G, McCullough MJ. Journal of oral pathology & medicine : official publication of the International Association of Oral Pathologists and the American Academy of Oral Pathology, 2019.