Polypharmacy and dentistry: I. Introduction and interactions with local anaesthetics and sedative drugs

Antidepressants relevant to oral and maxillofacial surgical practice

Background:

Depression is commonly associated with a high-carbohydrate diet, lack of interest in proper oral hygiene and xerostomia connected to the use of antidepressants. Patients often consult their dentists as a result of changes affecting the hard dental substance and the soft-tissues.

Aim:

The aim of this study was to identify adverse drug interactions between the antidepressants and medications commonly administered in dentistry in order to give practicing dentists an overview of the scientific literature.

Objective:

The objective is to identify the adverse drug interactions between antidepressants and medication commonly administered in dentistry.

Study Design:

The literature search was performed using PubMed, Cochrane and the specific search items. The review (1984-2009) focused on medicines used in dental practice (vasoconstrictors, non-opioid analgesics, non-steroidal anti-inflammatory drugs, antibiotics, antifungals and benzodiazepines).

Results:

There are various drug interactions between antidepressants and medicines used in dentistry. When two or more drugs are co-administered, a drug interaction must always be anticipated though many of the interactions are potential problems, but do not seem to be real clinical issues.

Conclusion:

The probability of a drug interaction can be minimized by careful history-taking, skillful dose adjustment and safe administration of the therapeutic agent.

Prescribed medication taken by patients attending general dental practice: changes over 20 years

INTRODUCTION

Drug therapy can influence treatment planning and provision of dental care by general dental practitioners. There is little published information regarding the types of drug therapy taken by patients presenting for dental treatment in the United Kingdom.

OBJECTIVE

To record the drug therapy taken by patients presenting to general dental practice in 1995 and 2005 and compare to data reported in 1984.

SETTING

General dental practice.

STUDY DESIGN

Prospective cross-sectional study.

METHOD

Patients presenting to general dental practices in 1995 and 2005 were questioned regarding their current drug therapy. Patients' general medical practitioners were contacted if their drug history was unclear.

RESULTS

35%, 21.1% and 43.8% of patients were taking medications in 1984, 1995 and 2005 respectively. Statistically significant increases in the proportion taking three or more medications were evident in both 1995 and 2005.

DISCUSSION

In 2005 more patients presenting to dental practice were taking medications compared to 1984. There is an increasing trend toward polypharmacy. Therefore it is important to maintain a contemporaneous knowledge of pharmacology and drug interactions to ensure the provision of safe dental care.

Drug profile of adult patients attending five general dental practices in Merseyside: oral side-effects and potential interactions with dentally prescribed medication

OBJECTIVE

To evaluate the drug profile of patients attending general dental practice and to assess the significance of this for the provision of dental care.

DESIGN AND SETTING

Prospective study of adult patients attending five general dental practices in Merseyside.

MATERIALS AND METHODS

Patients were questioned about prescribed medication. The data were analysed to assess any potential oral side-effects, pertinent drug interactions, or potential complications of dental treatment.

RESULTS

A total of 1103 patients were recruited; of these, 287 (26%) were taking systemic medication.

CONCLUSION

Approximately a quarter of dental patients attending for routine dental care were taking prescribed medication. The majority of these drugs have significant implications for the general dental practitioner.