Prescribing Pitfalls: How Common Medications Drive Micronutrient Deficiencies with Oral Health Consequences

Presented by:  Heather Fitzgerald, RD  

Original Lecture/ Publication Date: August 17, 2026 (Webinar Series)

Course Description:

Many of the medications prescribed most frequently in primary care—proton pump inhibitors, metformin, statins, oral contraceptives, diuretics, and long-term antibiotics—are known to deplete key micronutrients over time. These deficiencies often go unrecognized in general medical visits, yet many manifest first, or most visibly, in the oral cavity: delayed healing, gingival inflammation, altered taste, increased susceptibility to oral candidiasis, and compromised bone density affecting implant and periodontal outcomes. This lecture reviews the pharmacological mechanisms by which commonly prescribed drug classes interfere with nutrient absorption, metabolism, and utilization, and connects these mechanisms to findings dentists are positioned to observe chairside. The session also addresses how dental professionals can identify at-risk patients, communicate findings back to prescribing physicians, and support patients through nutrient-conscious care coordination.

Learning Objectives:

• Identify High-Risk Medication Classes
  Recognize the most commonly prescribed medications associated with clinically significant micronutrient depletion, including PPIs, metformin, statins, oral contraceptives, diuretics, and antibiotics.
• Understand the Mechanisms of Nutrient Depletion
  Explain how these medications interfere with nutrient absorption, metabolism, or excretion (e.g., PPI-induced hypochlorhydria reducing B12 and calcium absorption, metformin's effect on B12, diuretic-induced magnesium and zinc wasting).
• Recognize Oral Manifestations of Systemic Deficiency
  Correlate specific micronutrient deficiencies with oral findings such as glossitis, delayed wound healing, periodontal fragility, altered taste, and increased infection risk.
• Apply Interdisciplinary Screening and Referral Strategies
  Develop practical approaches for flagging at-risk patients based on medication history and coordinating with physicians or dietitians for nutrient repletion.

• Medication History as a Screening Tool
  Dentists can incorporate a brief medication review into intake to flag patients on long-term PPIs, metformin, or diuretics as candidates for closer monitoring of healing and periodontal status.
• Chairside Recognition of Deficiency Signs
  Providers can be trained to recognize oral signs (glossitis, angular cheilitis, slow healing) that may indicate an underlying drug-induced deficiency warranting referral.
• Collaborative Communication with Prescribers
  Dental teams can establish simple communication pathways with a patient's physician or dietitian when a deficiency is suspected, supporting earlier intervention and better surgical/periodontal outcomes.

Speaker Bio:

Heather Fitzgerald, RD is a Registered Dietitian with more than 25 years of experience specializing in Functional Medicine, metabolic health, hormone balance, and micronutrient deficiencies. Through her personalized, root-cause approach, and advanced diagnostic testing, Heather works with a wide range of concerns including hormonal imbalances, cardiovascular health and food sensitivities. She helps uncover the underlying imbalances contributing to chronic symptoms and supports them in restoring long-term wellness, energy, and vitality. Through her partnership with CLEAN Elements, she also helps clients optimize their home environments to reduce toxic exposures and create healthier spaces that support healing, balance, and overall well-being.

She currently has a private practice offering in-person and remote sessions for patients locally, nationally and internationally.