Codeine

Oral health effects

• Xerostomia (dry mouth)

  Opioids reduce salivary flow; chronic use raises caries risk, compounded by sugary drinks and neglected hygiene.

  Clinical management: Hydration, salivary substitutes, high-fluoride caries prevention; screen for substance-use considerations.

• Dizziness or fainting on standing (orthostatic hypotension)

  The label warns that Codeine can cause severe hypotension, including orthostatic hypotension and syncope, in ambulatory patients; risk is higher with volume depletion or other CNS depressants/antihypertensives.

  Clinical management: Raise the chair slowly at the end of treatment, let the patient sit upright for a minute or two before standing, and assist them out of the chair; take extra care in older patients and those also on antihypertensives, sedatives or other CNS depressants.