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When It Comes to Drug Interaction, Patients Get It

Certain medications cause drug interactions that can interfere with dental treatment.

Patients generally do a good job of informing their dentists of medications they are taking in order to avoid drug interactions, according to a dentist and expert in pharmacology issues.

"Yes, I think patients, generally, are very straightforward and they answer questions about their health truthfully," says Peter Jacobsen, Ph.D., D.D.S., professor and director of the Oral Medicine Clinic at University of the Pacific, San Francisco. "I think patients realize that the drugs used in dental procedures can complicate their medical problems and that they must work with their dentists to prevent problems."

In the past, says Dr. Jacobsen, many people were not comfortable divulging the medications they were taking. They could not understand why dentists needed to know. "They thought dentists were snooping around and being nosy," he laughs. "They didn't think their medical health was any business of the dentist."

Today, dentists are required to give patients a medical history form to complete that asks, among other things, about medication used. The dentists must then review the form with their patients and interview them about drug use, including illegal drug use.

"Almost any medical condition -- heart disease, HIV, cancer therapy, pregnancy, diabetes, to name just a few -- the dentist must be informed to deliver safe dental care," says Dr. Jacobsen. "Dentists know which medications they use that can cause adverse affects. For example, Erythromicin, an antibiotic used in place of penicillin, and Ketoconazol, an anti-fungal, can inhibit liver enzymes. Those are the two drugs that cause the most drug interactions. The dentist must know what drugs the patient is taking to avoid possible interactions."

Dr. Jacobsen notes that in the future dentists will need to ask patients about their use of alternative health products and therapies. "A recent study published in the Journal of the American Medical Association shows that about 43 percent of the American public participate in some kind of alternative therapy, including alternative oral care therapies," he says. "For example, some patients use herbal products such as echinacea, or use homeopathy products and therapies that may be affected by dental treatments or interact with other medications. We do not yet know because this area has been understudied in the past. However, don't be surprised if your dentist asks you about alternative therapies in the future."

Dr. Jacobsen says that basic knowledge of a product's ingredients can provide relief for patients. "For example, patients who have oral mouth sores -- canker sores, fever blisters or sores from trauma -- should avoid toothpastes that contain sodium laurel sulfate," he says. "Sodium laurel sulfate is a soap and irritates the sores. There are only two toothpastes that don't have it -- Biotene® Dry Mouth Toothpaste and Rembrandt® for Canker Sore Sufferers. They have no flavor and are perfect for those with oral sores."

Dr. Jacobsen advises patients to continue to discuss their medication use and medical conditions with their dentists. "The more the dentist knows, the more she or he can provide optimal care for the patient."

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