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Fast Facts: Perio Edition – Paxlovid Mouth

Fast Facts: Perio Edition Episode 78
[Andrew Johnston, RDH]
Welcome back everyone! You are listening to another episode of Fast Facts- Perio Edition brought to you by A Tale of Two Hygienists in partnership with DentistRX. And now, please welcome your host, Katrina Sanders.
[Katrina Sanders, RDH]
Hello, and welcome to Fast Facts Perio Edition. This week we have a cutting edge, pun intended, episode where we’re going to be talking about Paxlovid mouth. Now, Paxlovid is an interesting treatment. This is the first drug developed by Pfizer as a medication used to treat COVID-19. This drug was used as an emergency use drug. It was very quickly pushed through the FDA, and it is approved for individuals aged twelve or older who weigh at least 88 lbs, and specifically for individuals who are at high risk for severe disease. So many of our patients were likely prescribed this medication. It’s an oral antiviral pill that can be taken at home to help keep high risk patients from getting sick and needing to be hospitalized. And we’ve seen some really great results from this medication. In fact, there’s been almost a 90% reduction in the risk of hospitalizations and deaths in clinical trials. So this has really kind of been seen as a game changer, particularly in the infectious diseases space. However, as you can imagine, with any medication, the risk of side effects is always there. And this particular medication does have side effects that absolutely impact the work that we do in the oral cavity.
So Paxlovid, it actually has an additive product in it. This additive product is called Ritonavir, and this is an added medicament that is applied to a lot of different antiretroviral drugs. This medication component is used to boost antiviral medications, to boost those antiviral components. And unfortunately, one of the common side effects of Ritonavir is dysgeusia. In fact, about 6% of users who have taken this medication, Paxlovid, have reported some form of dysgeusia. And it’s interesting how our patients are describing Paxlovid mouth. They’re describing it anywhere from feeling like your mouth is clenched around a grapefruit rind, to sunbaked trash bag liquid, mmm yummy, a mouthful of dirty pennies, rotten soy milk, and here’s my favorite. “It was like the smell that hot garbage has, but in your mouth”. I don’t mean to laugh. In fact, I know that actually many dental professionals have shared with me that they were placed on Paxlovid and they absolutely experienced these particular side effects as well. So, as you can imagine, we’re starting to introduce some care modalities mostly just to manage these side effects. And so these are things like patients are being told to eat pineapple, or suck on lozenges or mints, stay hydrated by drinking flavored Pedialyte or chewing gum, or using mouthwash after use. And in extreme cases, medical doctors are encouraging our patients to drink chocolate milk or take a spoonful of peanut butter before taking a dose in order to coat the mouth. So we are likely going to see some Cariogenic trends down the road based on some of the pieces that are required in having to manage the sequelae of this medication. Be sure if you have a patient who has taken Paxlovid that you are inquiring about if they’re still experiencing dysgeusia, and if so, how it is that they’re managing it. Thank you for tuning in today for another Fast Facts Perio Edition with Katrina Sanders. I hope that kept you on the cutting edge of your seat. Stay tuned as we continue some fun perio facts next week.
This has been another episode of Fast Facts – Perio Edition with Katrina Sanders, RDH. Please feel free to reach me on Instagram @thedentalwinegenist or on my website www.KatrinaSanders.com Cheers.
[Andrew Johnston, RDH]
Thank you for listening to another episode of Fast Facts – Perio Edition, brought to you in part by DentistRX makers of the InteliSonic line of power brushes. Find out more by visiting their website at www.dentistrx.com. We’ll see you next week for another Fast Fact!

Resource: ​​
Brooks, J. K., Song, J. H., & Sultan, A. S. (2022). Paxlovid‐associated dysgeusia.Oral Diseases

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