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Studies show that
two out of every five adults take some type of medication that could have
dental related side effects. With age, this chance doubles!
Some of the more
common side effects are:
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Dry mouth-Antihistamines
are know to decrease saliva leaving your mouth prone to inflamed,
painful gums making them susceptible to infection. Decrease in
saliva can cause an increase in tooth decay. Denture wears can
develop sores.
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Aspirin Damage
People who often chew aspirin over a prolonged period
could severely damage their teeth.
The first case focused on a 52-year-old woman that had
been taking four to eight aspirin tablets a day for one to
two years to relieve headaches. She typically held the
aspirin tablets on the tooth surfaces and crushed them until
they dissolved causing the tooth surfaces that most often
came in contact with aspirin to eroded the most. A
42-year-old male patient stated that he had used aspirin or
acetaminophen daily. He took an average of six aspirin a
day. He put the aspirin in his mouth on his right posterior
teeth and crushed them. When we showed the tooth
destruction to the patient, he confirmed that the worst
areas were, indeed, where he held the aspirin tablets.
Journal of the American Dental Association (JADA)7/04 |
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Soft-tissue reactions-Medications for
blood pressure control, immunosuppressive agents, oral contraceptives
and chemotherapeutic agents can cause oral sores, inflammation and
discoloration of gum tissue.
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Abnormal bleeding-Aspirin,
anticogulants, like warfarin and heparin can cause bleeding and blood
clotting problems during oral surgery or periodontal
treatment .
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 | Coumadin-is a
blood thinner that works by interfering with the liver's
production of vitamin K dependent blood clotting
factors. When you take a blood thinner, there are
concerns that you may bleed unusually heavily after an
extraction or having your teeth cleaned. It is important
that your doctor’s office contact us with a recent INR
result before you have a cleaning,
root planing, or
any kind of dental surgery including
extraction or gum surgery. The
INR result helps decide whether we can do the procedure with
a high level of safety. We can’t stress enough that
our office must have good communication with your doctor to
insure the greatest safety for you. Doctors relay on a blood test called Prothrombin Time to know if levels are too high or
low. Normal PT reading if 1.0 which is equivalent to
10-12 seconds. People on coumadin generally have 2.0
or twice the normal reading. When PT number
increases, there is a greater risk of increased
bleeding. PT times between 1.5-1.8 or less are safe
readings for a person to have dental
surgery. Due to taking coumadin you may need
additional measures to stop the bleeding from dental
surgery like packing and stitching of the socket.
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Gum tissue overgrowth-This is know as
gingival hyperplasia. It is associated with anti-seizure
medication, medications for organ transplants and calcium channel
blockers. This condition makes good oral
hygiene care difficult.
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Tooth
discoloration-Tetracycline products used when teeth are developing
can cause permanent staining in teeth.
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Where to report drug
interactions:
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Keep a
list of all the medications, over the counter medicines and herbal remedies
you are currently using and bring it to each of your appointments with
your doctor or dentist.
Up To Top
Top ten most commonly
prescribed drugs are:
- Hydrocodone/APAP
(generic)
- Atorvastatin (Lipitor)
- Levothyroxine (Synthroid)
- Atenolol (generic)
- Azithromycin (Zithromax)
- Amoxicillin (generic)
- Furosemide (generic)
- Hydrochlorothiazide
(generic)
- Amlodipine (Norvasc)
- Lisinopril (generic)
To learn more about
prescriptions your patients may be taking, visit
www.rxlist.com
12/05 |
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Prescription drugs can interact with a variety of foods
Eating fruits and vegetables is essential to
living a long and healthy life, yet research has shown they can
cause dangerous interactions with medicines. Foods can
increase or decrease the activity and toxicity of
orally-administered drugs (intravenous drugs are not
altered).
One of the most studied of these interactions
is the inhibition of CYP3A4 enzymes caused by grapefruit
or its juice. CYP3A4 enzymes are responsible for the
metabolism of more than 60 percent of orally-administered drugs.
Drugs that interact with grapefruit include:
 | anti-infectives |
 | anti-inflammatories |
 | cardiovascular agents |
 | central nervous system agents |
 | estrogens |
 | gastrointestinal agents |
 | Histamine H1 antagonists |
 | immunosuppressives |
 | erectile dysfunction drugs. |
Dental patients in particular should be
aware of interactions with the sedatives triazolam, midazolam
and diazepam which could cause excessive sedation.
As little as 6.0 oz of grapefruit juice may
lower the amount of a drug needed to produce the desired effect,
which could cause an overdose. The blood that absorbs
nutrients passes through the liver before reaching the general
circulatory system (the first-pass). The ability of a drug to
successfully pass from the GI tract to the plasma is called its
bioavailability. Grapefruit juice inhibits first-pass drug
metabolism, increasing bioavailability.
Many elderly patients vacation or spend
winters in southern states such as Florida , where they may be
more likely to consume grapefruit and other fruits that may
interact with prescribed medicines. The components of grapefruit
juice believed to be clinically active are also found in limes,
pumellos, and Seville oranges. Natural food products, citrus
products and cabernet sauvignon wine are also known to interact
with drugs. This interaction can increase the
concentration of drugs in the bloodstream and enhance their
potency, which can result in toxicity.
While most people know to ask their
pharmacists about possible interactions between medicines, many
don't realize they should also be asking about the foods in
their refrigerator. Remember use caution because there are
probably more food and beverage interactions that have not yet
been discovered.
There are ways to protect against food/drug
interactions.
 | Patients should refrain from
grapefruit consumption for 24 to 48 hours before and during
drug therapy. |
 | Be sure to read the drug information
flyer provided in every prescribed drug and question their
pharmacist. |
 | Be sure to report any unusual drug
effect. |
AGD 10/05
February 06, 2008
Premedication Index
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