Spironolactone Does Not Cause Receding Gums
There is no evidence linking spironolactone to gingival recession or receding gum lines. The comprehensive safety profiles documented in dermatology guidelines do not list periodontal effects among the known adverse reactions of spironolactone 1, 2.
Documented Side Effects of Spironolactone
The well-established adverse effect profile of spironolactone includes 1, 2:
- Menstrual irregularities (15-30% of patients, dose-dependent) 1
- Breast tenderness (3-5%) 1
- Dizziness (3-4%) 1
- Nausea (2-4%) 1
- Headache (2-20%, with 20.4% in controlled trials versus 12% with placebo) 1, 3
- Polyuria/diuresis (1-2%) 2
- Fatigue (1-2%) 2
- Hyperkalemia (primarily in patients with renal or cardiac impairment) 2
Notably absent from this extensive list is any mention of gingival or periodontal effects 1, 2.
What Actually Causes Gingival Recession
Gum recession results from multiple well-documented factors 4:
- Inflammation and periodontal disease 4
- Mechanical trauma from improper brushing technique 4
- Chemical damage 4
- Smoking 4
- Tartar accumulation 4
- Genetic predispositions 4
- Orthodontic treatment 4
- Occlusal overload 4
Potential Indirect Considerations
While spironolactone does not directly cause gingival recession, one theoretical consideration exists:
- Spironolactone causes diuresis in 1-2% of patients 2, which could theoretically affect oral hydration
- However, this effect is mild and has not been linked to periodontal complications in clinical practice 1, 2
Interestingly, experimental animal research showed spironolactone had no significant effect on alveolar bone destruction in periodontitis models, suggesting it neither helps nor harms periodontal tissues 5.
Clinical Implications
If a patient on spironolactone develops receding gums, investigate standard periodontal risk factors rather than attributing it to the medication 4. Focus on:
- Brushing technique and oral hygiene practices 4
- Presence of inflammation or periodontal disease 4
- Smoking status 4
- Genetic factors and immune system abnormalities 4
The extensive safety data from large cohort studies involving millions of patient-years has not identified periodontal effects as a concern with spironolactone therapy 1.