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It is important that
your dentist has all the information,
including your medical history, herbal
and conventional drugs you are taking.
Recommendations Before Surgery
Tell your Dentist
Alternative medicine or "natural
remedies" for dental care have been around for centuries only now
there is research to prove if they are effective or just old wives
Always tell your
dentist about all medications and supplements you are taking and how
much you take.
We do caution you when using
any alternative "natural" treatments including herbal
supplements. Remember that even the most common herbs such as St.
John's Wort and Ginko Biloba can cause serious health problems if taken
in combination with other drugs or in extreme dosages.
These medication are not just ground up herbs, but are
actually derived from the potent oils of the plants. These
natural medication are capable of dangerous drug interactions that
can put a person at an increased risk for a complication during
and after dental treatment.
- Blood thinners, such as the popular ginkgo
biloba and even vitamin E can be dangerous when taken
with aspirin, which also acts as a blood thinner. Because this may
cause a situation in which some patients' blood will have difficulty
Vitamin C, when taken in the thousands of
grams can cause problems and weaken the efficiency of anesthesia.
Calming supplement, such as Kava
Kava or St. John's Wort and Valerian**** can enhance the effects of the
anesthesia to cause problems. It is recommended to gradually
discontinue the use of valerian and kava 7 days prior to anesthesia because
of its potential to enhance the sedative effects of agents used in
general anesthesia. ^
Garlic can cause bleeding though platelet
aggregation and it can increase the action of coumadin and warfarin
in anticoagulant therapy. It is recommended that you discontinue
the use of garlic at least seven days prior to surgery. ^
Dandelion and bearberry are both
herbal supplements that are said to work as a diuretic. These can
interact with and over-enhance the effects of prescription
diuretics, which can lead to dehydration, loss of potassium in the
body, and even disrupt heart-rhythm.
Enforcement of LB 113**
|Ginkgo may also increase gum disease.
Gingko affects the platelets in the blood stream that cause the clotting|
mechanism to occur after an injury. Patients taking gingko may bleed through their gums, and the product may cause
uncontrollable bleeding or speed up existing gum disease.
Bleeding time is prolonged when ginkgo is used with aspirin
|If you take aspirin frequently, you may want to
pass on ginkgo biloba.|
|Gingko biloba has anti-platelet properties that
may reduce blood clotting.
Aspirin is an anticoagulant, or blood thinner,|
that also may
increase the time it
takes for blood to clot. Thus, combining gingko use with
daily or frequent
aspirin use could increase the risk of bleeding complications.
Ask your doctor before taking both regularly.
|The following herbal medications can also cause
an increase in
bleeding when combined with prescription or over the counter
drugs...garlic, Melilot, Sweetwoodruff, Horse Chestnut, Cinnabar
root, Alfalfa, Dong quai, Barberry, |
Feverfew and Bromelains. These herbs increase the action of
blood thinners Coumadin,
Warfarin and other coumadin
Feverfew, garlic, ginger, ginkgo-
This is a resolution to protect the public from
illegal ephedrine containing food/herbal supplements that can cause:
through increased heart rate|
|risk of heart attacks|
|risk of heart ischemia, stroke and
Dosage unit is not to exceed 25 mg of ephedrine.
Maximum recommended dosage in 24 hours is 100mg or less. The label
must contain a warning statement. It is recommended that you discontinue this
herb at least 24 hours prior to surgery.
Avoid mixing Ephedra with:
Combined with these drugs, it becomes even more
risky. Ephedra is a potent herb that is present in many
products, especially those designed to give pep or lose weight. It
goes by many names, such as ma huang, herbal ecstasy, mahuang,
mahuanggen and ma huang root. Suspect any "natural"
product that claims to cause weight loss or increase energy to
have ephedra in it, and review the product's contents with your
doctor or pharmacist before assuming it doesn't.
Echinacea-possible problems with allergic
reactions ,decreased effectiveness of immunosuppressants and
possible immune suppressant with long-term use (more than 8
weeks). Long term use increases the risk of poor wound healing
and opportunistic infections. Echinacea increases your immune
response but should be taken for two weeks or less. Taken long
term, it may actually decrease your body’s ability to fight disease.
Acts to Reduce Potential Risks with Ephedra
You should discontinue taking Echinacea
as far in advance as possible of medical surgery.^ Avoid mixing
|Amiodarone (Cordarone, Pacerone), used to
|Methotrexate (Methotrexate), used to treat
|Ketoconazole (Nizoral), an antifungal drug|
Feverfew-can increase bleeding and it can
increase the action of coumadin and warfarin in anticoagulant
Ginseng can cause bleeding and hypoglycemia
by lowering blood sugar. It is recommended to discontinue ginseng
use at least seven day prior to surgery.^ Avoid
|Cyclosporine (Neoral, Sandimmune, SangCya),
Echinacea can be toxic to the liver and
shouldn't be combined with other drugs
that can cause liver damage.
|Warfarin (Coumadin), an anticoagulant-this
combination could cause bleeding |
|Phenelzine sulfate (Nardil), an
antidepressant-could caue headache, trembling,|
Sanguinarine is not recommended due to its
links to predisposing gum tissue to oral cancer.
The herb ma huang, known as ephedra,
has been associated with stroke, heart attack, and sudden death.
Ma huang is an herbal source of ephedrine, a powerful stimulant
found in weight-loss and energy supplements. People with heart
conditions should be especially careful to avoid stimulants.
Melilot, sweet woodruff, horse chestnut, cinnabar
root, alfalfa, dong qui, barberry, goldenseal, Oregon grape,
bromelains can increase the action of blood thinners like coumadin
Garlic, Gingko and Feverfew can increase the effectiveness
of aspirin and can greatly increase bleeding.
Cassia cinnamon can decrease the effectiveness of
tetracycline by up to 80%. Tetracycline can be used to help
treat gum disease.
Agrimonia eupatoria, agropyrum repens, alchemilla
arvensis, alisma plantago, anacyculus purethrum, bearberry, black
cohosh, hawthorn, sassafras, dandelion and viola tricolor can cause
hypotension when taken with medications prescribed for
hypertension. Caution needs to be used when getting out of the
dental chair after being in a laid back position.
St John's Wort can cause drowsiness and
sensitivity to light. It interferes with the effectiveness of
other drugs such as Versed, Valium and Halcion, Coumadin and digoxin
and Tylenol. Due to its ability to diminish the actions of
other drugs it is recommended you discontinue its used five days
prior to surgery. ^
|Digoxin (Lanoxicaps, Lanoxin)-could interfere
with its pharmacologic action|
Avoid mixing St John's Wort with any
prescription medications. In particular,
avoid taking St. John's Wort with:
|Antidepressants-combination of SJW with some
antidepressants, such as |
selective serotonin reuptake inhibitor, may cause excess of
symptoms include headache, stomach upset and restlessness.
|Indinavir sulfate (Crixivan), a protease
inhibitor used to treat HIV|
|Digoxin (Lanoxicaps, Lanoxin), a drug used to
increase the force of contraction|
of heart muscle and to regulate heartbeats
|Theophylline (Slo-bid, Theo-Dur), an asthma
|Cyclosporin (Neoral, Sandimmune, SangCya) an
SJW has been shown to affect your body's
metabolism of all of these drugs.
Many other drugs are likely to be affected
too. Until more is known about SJW's ability
to alter the metabolism of pharmaceutical
medications, it is probably best not to
combine such medications with SJW.
Kava alert: Avoid mixing
|Drugs used to treat anxiety or Parkinson's
Valerian-The medical concern is that is has
the potential to enhance the sedative effects of agents used in
general anesthesia. It is recommended to discontinue use of
valerian prior to anesthesia. If you are taking large
doses of this medication it is recommended you not abruptly
discontinue this medication but slowly decrease taking this herb in
order to prevent withdrawal symptoms.
- The FDA Center for Food Safety and Applied
Nutrition notified of the potential risk of severe liver injury associated with
the use of kava-containing dietary supplements. Supplements
containing the herbal ingredient kava are promoted
for relaxation (e.g.,
to relieve stress, anxiety, and tension), sleeplessness,
menopausal symptoms and other uses. Kava-containing products have been associated
with liver-related injuries, including hepatitis, cirrhosis, and
failure. Kava can be listed under different names...Piper Methysticum,
pepper, sakau and Tonga. Given these reports, persons who have liver
or liver problems or persons who are taking drug products that can
the liver, should consult a physician before using
Cayenne-Avoid mixing with:
|Angiotensin-converting enzyme (ACE)
inhibitors, drugs used for diabetic kidney|
disease, heart failure, high blood pressure.
|Theophylline (Slo-bid, Theo-Dur), an asthma
|Cayenne may increase the absorption and
impact of these drugs. It may also increase the
likelihood of developing a |
cough when used with ACE inhibitor.
20. Herbal tea may be harmful to teeth
-Dentists have warned herbal tea lovers that their favorite
drink may be harming their teeth. According to a report published in the
Journal of Dentistry, herbal tea can erode the protective layers of
enamel that surround every tooth. It may be a healthier alternative
to the more traditional cup of tea. Many of the teas they tested were acidic
enough to erode tooth enamel. They also found that some were up to three
times more acidic than fruit juice. It was suggested to avoid herbal
and fruit teas. MG Worldwide Ltd 2003
21. Methotrexate-Sudden death..Bill-Internet
health comment 10/05
The greatest risk for a complication from dental
procedures like having a tooth removed,
root planing and scaling, gum
surgery, biopsies. Excessive
bleeding can hamper routine dental treatment such as dental
cleaning, fillings and crowns.
Before Having Dental Surgery, if you use any of these herbal medications
stop taking them:
|Ephedra at least 24 hours before surgery|
|Garlic 7 days before surgery|
|Ginkgo 36 hours before |
|Ginseng 7 days before surgery|
|Kava 24 hours before |
|St. John's Wort 5 days before surgery****|
occurring mineral has been proven to protect teeth from decay.|
dries out the mouth which can cause discomfort and create an
environment for more plaque to thrive.|
|Tea-wet tea bags can give relief from canker
sores, swollen gums, toothaches and stop bleeding after extraction.|
|Natural preventive treatment for cold sores-A
diet that is high in lysine and low in arginine has
been found to be helpful. In vitro studies indicate that the amino
acid arginine is required by the herpes virus to replicate. Since
lysine competes with arginine for intestinal transport, a diet rich
in lysine (brewers yeast, legumes, dairy, wheat germ, fish and meat)
and low in arginine may have an antiviral effect. Chocolate, peanuts
and almonds are high in arginine and should be avoided. In addition
to dietary changes, lysine supplements are recommended. A dose of
1,000 mg taken three times a day has been shown to be effective.
This approach is not curative but can help prevent recurrences|
|Green tea halts growth of oral cancer cells and
breaks down and kills existing oral cancer. Ingesting or
swishing with green tea introduces the tea polyphenols to the oral
cancer cells which may be present in the mouth. The
polyphenols are antioxidants, which work to remove the free radicals
(oxidants) that cause mutation of genes, which may lead to cancerous
growth to prevent gene mutations from the actions of the oxidants
and cause cell death in cancerous cells without harming the normal
cells. They can also inhibit the growth and spread of
cancerous cells. The mouth's mucous lining must be exposed
to four to six cups of green tea a day^^. This study
suggest the use of green tea as a beverage or in oral health
and skin care products is likely to be beneficial in helping to
prevent oral cancer. +++|
|Zinc- available in lozenges to relieve pain
of sore throat. Topical applications of zinc can reduce symptoms and
prevent cold sores recurrences. It is applied directly to the skin at the site of the flare-up. Zinc
can also be used to help alleviate cold and flu symptoms.|
|Lemon Balm-lemon balm cream promoted the
healing of cold sore blisters in 5 days . Used on regularly, lemon
balm cream can decrease the frequency of recurrences.|
|Honey-has enzymes that contain antibacterial
quality...phytochemicals which act as antioxidants to prevent the
erosion of tissue surrounding teeth as a result of an
infection*. Caution, honey can vary widely in the potency of
its antibacterial agents and should not be given to children under
|Plant Aloe Vera:
|Relieve a Cold
Sore-anti-viral and anti-inflammatory properties, aloe vera
provides additional benefits to the skin, such as amino acids,
B1,B2,B6 and C vitamins |
|Dentists are recommending patients to consume aloe
vera juice to treat various internal ulcerations
of the mouth, including apthous ulcer, lichen planus
and oral mucus membranes. Recent findings show that aloe vera
cleared up oral lesions associated with lichen planus better
than any other traditional treatments.|
Problems Aloe vera: Natural, home
remedy treats canker and cold sores
New reports prove that the aloe vera
plant, which has been used to heal skin for more than 2,000
years, can also treat many oral health problems including canker
sores, cold sores, herpes simplex viruses, lichen planus and
gingivitis. There is good evidence to support using aloe
vera for oral health problems because it is alsoan
Aloe vera accelerates healing and reduces
pain associated with canker sores, which are blisters on the
lips or mouth. Aloe vera does not have a bad taste or sting
when applied. Patients can drank 2.0 ounces of aloe vera
juice daily and apply topical aloe vera lip balm. The oral
lesions may clear up in four weeks and complete success can be
achieved. Thus Aloe vera can be taken both as the aloe vera
juice and aloe vera gel. Those
interested in using aloe vera for oral health problems are
encouraged to speak with a dentist for proper treatment
Treatment and use of aloe vera plants
Aloe vera plants are available at
most plant stores and nurseries.
Place near a window.
Water when the soil is dry.
Do not over water.
To get the gel out of the plant, use
scissors to snip off an inch of the leaf.
Squeeze the leaf that was snipped
off. The gel will squeeze out.
January/February issue of
Dentistry, Richard L. Wynn, PhD, the Academy of
General Dentistry's (AGD) 2005
|Oil of calendula - For mouth wounds like
|Plant-derived amica - Can be useful to
patients after a tooth extraction or
after oral surgery. It responds to minor trauma|
|Valerian - To calm nervous or anxious
patients who are interested in an alternative to nitrous oxide***|
|Barberry Bark- To treat bad breath+|
|Horehound-To treat acute or chronic sore throats
|Myrrh Gum- Removes bad breath+|
|Speedwell-Used as a gargle for mouth and
|Ginger Root-Remedy for a sore throat+|
|Echinacea Root-To treat strep throat+|
|More Tea, Less Cavities --
drinking black tea can help prevent gum
disease and fight cavities by rinsing
your month with black tea. Rinsing for 1 minute, 10 times a day
resulted in a decrease in plaque build-up. The chemicals in black
tea, called polyphenols, suppress the growth of cavity-causing
bacteria in plaque and reduce acid production levels. So drinking
black tea could reduce the number of cavities and prevent
periodontal disease. American Society for Microbiology 101st
General Meeting, Orlando, Fla.Ivanhoe Newswire
(August 29, 2002) ORLANDO, Fla. (Ivanhoe Newswire) May 23, 2001|
|Natural Whitening: Brush
with your normal toothpaste and rinse as usual. Dip the brush into
baking soda and brush again with that for one full minute.. Rinse
with mouthwash. Once Weekly: Substitute the following regimen for
one brushing each week:Mix two teaspoons baking soda with
enough hydrogen peroxide to make a thick paste. ... Brush and allow
the mixture to remain on your teeth for at least two minutes. Do not
swallow this mixture. Rinse. Brush again with your regular.|
and dilute a 4oz bottle with a gallon of water ...it has the same
effects as chlorhexdine|
Always tell your
dentist about all medications and supplements you are taking and how much
you take from vitamins to Echinacea, everything you put in your body
causes a certain reaction, and some alternative medicines are very potent.
They can react and interfere with medications your dentist gives you or
enhance them to cause a much stronger reaction.
dentist doesn't know what drugs or supplements you have taken, he or she
will not know how to protect you from possible substance interactions
To learn more about herbs:
National Center for Complementary and Alternative Medicine Alternative
Food and Drug Administration
** Dentalnotes pg 3, Fall 2001
Medicine Sept 23,01.
+Only limited scientific investigation supports these claims AGD.
****JADA News Vol 132, October 2001 pg 1378.
^^The research was supported by a grant from the American Cancer
^^Dentalnotes, Winter 2001 pg 1
++FDA Probes Anti-Anxiety Herb, MedlinePlus 02/02
JAMA Vol 286, #2 pg 208, 2001.
+++Chemoprevention of Oral Cancer by Green Tea; Biochemistry 11/01; Dr.
Hsu, Dr Singh, Fr Lewis, Dr Borke, Dr. Dickinson, Ms Drake, Dr. Caughman,
^Herbal Remedies, General Dentistry; Dr. Wynn, pg 14-20 Jan-Feb 2002.
**Check to see if the
supplement you are considering is registered with the state by calling
402-471-2118 or check at www.hhs.state.ne.us;
go to Department of Regulation & Licensure. To report ephedrine
products not meeting the above labeling statues, call HHS Investigations
Division 402-471-0175 and provide: Name & distributor of product;
location of store where found; date product found; copy of advertisement
materials or verbiage from label and any conversion you had with
salesperson or owner.
1998-2002 Mayo Foundation for Medical Education and Research.
February 06, 2008
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