Clinical Oral Investigations

, Volume 23, Issue 5, pp 2339–2344 | Cite as

Long-term scopolamine treatment and dental caries

  • Eran Galili
  • Elor Averbuch Zehavi
  • Yehuda Zadik
  • Tomm Caspi
  • Liron Meltzer
  • Ilan Merdler
  • Jonathan Kuten
  • Dror Tal
Original Article



To investigate whether scopolamine, an anticholinergic agent which induces hyposalivation, represents a risk factor for the occurrence of dental caries.

Materials and methods

A retrospective cohort study was carried out among sailors treated with scopolamine for seasickness. The study population included 370 young healthy male adults (18–30 years old) who served in the Israel Navy between 2012 and 2016. Of these, 66 subjects who were chronically treated with intermittent administration of scopolamine, either by the oral or transdermal route, were assigned to the study group. Documented subject characteristics included age, socioeconomic status, level of education, body mass index, smoking history, and dental hygiene. Follow-up lasted 1 to 3.5 years.


Two- to 3.5-year follow-up revealed a higher risk of dental caries in 15 of 16 subjects (93.8%) treated with an average of 50.9 mg scopolamine, in contrast to only 71 of 108 control subjects (65.7%) (RR = 1.43, p = 0.02 [95% CI = 1.18–1.72]). Follow-up for 1–1.5 years revealed a lower occurrence of dental caries in both the study group (11/22, 50.0%) and the control group (46/104, 44.2%). Follow-up of 1.5–2 years also revealed less dental caries, in 16/28 subjects (57.1%) in the study group and 51/92 subjects (55.4%) in the control group. The differences were not statistically significant.


In healthy young adults, prolonged intermittent use of scopolamine was found to be a risk factor for the development of dental caries.

Clinical significance

Dental care and hygiene should be intensified when administering hyposalivatory anticholinergic agents.


Dental caries Hyoscine Scopolamine Xerostomia 



We are grateful to Richard Lincoln of the Israel Naval Medical Institute for help in editing the manuscript. We thank the enlisted paramedics of the Israel Defense Forces 3rd Flotilla and the staff of the Naval Dental Clinic for gathering some of the data.


This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Compliance with ethical standards

Conflicts of interest

The authors declare that they have no conflict of interest.

Ethical approval

Ethical approval for this study was obtained from the IDF Institutional Review Board.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Eran Galili
    • 1
    • 2
    • 3
  • Elor Averbuch Zehavi
    • 4
  • Yehuda Zadik
    • 4
    • 5
  • Tomm Caspi
    • 2
  • Liron Meltzer
    • 2
  • Ilan Merdler
    • 3
    • 6
  • Jonathan Kuten
    • 3
    • 6
  • Dror Tal
    • 7
  1. 1.Department of DermatologySheba Medical CenterTel HashomerIsrael
  2. 2.Israel Defense Forces Medical CorpsTel HashomerIsrael
  3. 3.Sackler Faculty of MedicineTel Aviv UniversityTel AvivIsrael
  4. 4.Department of Oral Medicine, The Oral and Maxillofacial Center, Medical CorpsIsrael Defense ForcesTel HashomerIsrael
  5. 5.Department of Oral Medicine, Sedation and Maxillofacial ImagingHebrew University-Hadassah School of Dental MedicineJerusalemIsrael
  6. 6.Tel Aviv Sourasky Medical CenterTel AvivIsrael
  7. 7.Motion Sickness and Human Performance LaboratoryThe Israel Naval Medical InstituteHaifaIsrael

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