Oral Health and Dental Management

D.D.D. (“Do and Don’t Do”): A dental dogma; drug interactions in dental practice

4^th Asia Pacific Congress & Expo on Dental and Oral Health

July 27-29, 2015 Brisbane, Australia

Adi A Garfunkel

Posters-Accepted Abstracts: Oral Health Dent Manag

Abstract:

Advanced dental treatments demand extensive use of local anesthetics, vasoconstrictors, analgesics, tranquilizers, antibiotics and anti-inflammators. The lecture material will relate to interactions between ?dental medications? and the most common physician prescribed ones. Heart patients treated with cardiotonics, diuretics and vasodilatators need special consideration. The amounts and types of local anesthetics and vasoconstrictors have to be administered accordingly. Patients with arrhythmia present a major challenge. Antithrombotic and anticoagulant drugs interact with antibiotic and anti-inflammatory drugs. Even anti-hyperlipidemics require avoidance of certain antibiotics use. Three factors with which the dentist has to cope appeared on the scene in modern times. One is the complex, prolonged and invasive treatment with multiple implants. The other is the growing aged population requiring these treatments. And the last is the continuous changing in medications prescribed by the physicians to these patients. Advanced dental treatments require the use of local anesthetics containing vasoconstrictors. Avoiding the use of vasoconstrictors could lead to failures in anesthesia. Their excessive use could endanger the patient health and even life. How do we use them safely? Antithrombotic and anticoagulant drugs lead to an increased bleeding tendency. Interruption of antiplatelet treatment previous to surgical interventions might have catastrophic results. What is the dental surgeon?s protocol for preventing these failures? Patients treated with cardiotonics might need sedation. The use of diazepam (valium) is dangerous. How do we safely sedate them? Will the medical treatment of these patients fail if we administer antibiotics? Learning objectives: 1. To design a scientifically based preoperative assessment. 2. To understand the mechanism of drug-drug interactions. 3. To minimize drug toxicity and side effects. 4. To use ?dental drugs? intelligently in light of their interactions with the most widely prescribed medications. 5. To define the DDD (?Do and Don?t Do?) recommendations for medically complex patients.