September 2006
Volume 2, Issue 7

From the Editor

Gerard Kugel, DMD, MS, PhD

Dear Readers:

As always, everyone at Inside Dentistry would like to thank you for your continued support. In this issue, we look at dental pharmacology, dentists’ prescribing habits, and what’s changed in practice over the years. Although we are becoming savvier in our use of pharmaceuticals, dental practitioners must be mindful not to adversely affect the health and well-being of our patients and the reputation of our profession.

Sedation Dentistry. There is a recent trend for dentists to sedate patients before performing many dental procedures. As a profession, we must assess if this practice is safe or if it is just an excuse for not dealing with difficult patients. Because it’s important for us to interact with our patients in order to understand their needs and feelings, as well as what they’re experiencing, we must evaluate whether or not sedation dentistry is necessary on a case-by-case basis. No drug is completely safe; those who choose to offer and provide sedation dentistry must be well-trained before attempting this aspect of dental treatments. A two-day seminar at a dental convention or elsewhere may not be sufficient. As with anything we do in dentistry, there should be a risk/benefit analysis in our treatment planning.

Antibiotics. When prescribing antibiotics, dentists need to exercise greater selectivity.  Different bacteria and, hence, infections are becoming increasingly resistant to certain antibiotics due to overuse. When dentists prescribe antibiotics for something minor, or as a preventative, we run the risk of increasing bacterial resistance to these antibiotics. As stated by the FDA, “Disease-causing microbes that have become resistant to drug therapy are an increasing public health problem. Tuberculosis, gonorrhea, malaria, and childhood ear infections are just a few of the diseases that have become hard to treat with antibiotic drugs.” Therefore, antibiotics should be prescribed cautiously. For more information, please refer to the CDC Web site and search “drug resistance.”

What to Know Today. People are taking more medications now than ever before. In the past, many patients in our practices were medication-free. Today, it’s not uncommon for a 16-year-old to sit in the dental chair and already be taking three or more prescriptions. As this month’s cover feature emphasizes, we need to know every drug a patient is taking, as well as their medical history. Diligent attention to the pharmacology of these medications and how they may affect the dental appointment can help clinicians in best prescribing for their patients.

On behalf of everyone at Inside Dentistry, we hope you enjoy this issue. We encourage you to send your thoughts and reactions to our clinical content and, in particular, our editorial coverage of this topic, to letters@insidedentistry.net. Again, thank you for reading.

With sincere thanks,

Gerard Kugel, DMD, MS, PhD
Associate Dean for Research
Tufts University School of Dental Medicine
gkugel@aegiscomm.com

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