Introduction to dental medications.
Dental Work as other medical fields , requiring application of therapeutics to treat, control, prevent, .... etc conditions.
Here, we are going to talk about different medications, drug classifications, doses, side effects, Interactions, brand names, ... etc.
the dental field contains a lot of diseases, Syndromes, Conditions altering the treatment modality and requiring different drugs, so that there are a lot of drugs to the dentist that may prescribe, furthermore, there are a lot of drugs that the dentists should know as they cause conditions in oral cavity, leading to a diagnosis of medical condition in the patient Or even may have interactions with drugs you're welling to prescribe.
Drugs used in dentistry are a lot, simply, can be classified into:
• Medications used to control pain and anxiety
• Analgesics
• Antibiotics
• Anesthetics
• Medications used to treat dental infections
• Antifungals
• Other dental medications
----------------------------------
Chapter One: Medications used to control pain and anxiety
Dental treatment includes pain, In almost all the procedures ex: reduction, cavity preparation, surgery, sublingual scaling, … etc., then, the dentist should be care about this point, because, the dental Client (Patient) who comes to the dental office seeking treatment is almost nearly 90% afraids from what is called a dentist, then it becomes one of the most important success factors of the dentist in his work in the point of view of the patient is feeling comfortable in treatment without pain. AS one of the most reported Complication by clients is PAIN.
Dental Procedures is then accompanied with control of pain and sedation, with different procedures, including psychological control of pain, medication, anesthesia, sedation, Anxiety reduction protocol, and much more.
Here In this article we will discuss those drugs that include control of pain and anxiety, but NOW in this part of the article we will discuss the general view of the next chapters.
Several medications are available to help create more relaxed, comfortable dental visits. Some of the medications make the client feel no pain during the treatment, while the others can make him relax and others make him sleep completely.
----------------------------------
How can we choose the way to control pain and anxiety for the Client?
First of all, the dentist should discuss with the patient the procedures that will be done, the overall health of the client, history of allergies and your anxiety level befor any approach is to be chosen.
----------------------------------
Basics to follow when choosing drug for relieving pain.
Analgesics are the drugs that are used for relieving pain, the Minor dental procedures (Non-surgical) requires a little relieving drugs, so the Non-narcotic are the drugs of choice, while the more invasive surgical procedures including oral and maxillofacial surgeries requires the narcotic analgesics as it works in the CNS (will be discuss later in the Chapter Three).
Before the dental procedure is to take place, the dentist should decide to put the client in the status of “FREE OF PAIN” then the anesthesia should be taken in consideration. The Anesthesia is classified into local and general anesthesia, while most of dental procedures requires the local, then it be used in almost all the cases, but the general anesthesia will be used in Oral and Maxillofacial surgeries, in completely un-cooperative patients or for child patient where the cavity preparation is nearly impossible.
----------------------------------
What is the Anxiety and how it can be controlled?
Anxiety is a psychological and physiological state characterized by somatic, emotional, cognitive, and behavioral components.[2] It is the displeasing feeling of fear and concern. (Wikipedia)
Anxiety can be controlled by the anti-anxiety drugs, such as nitrous oxide, or by sedatives, tranquilizers, Or By Anxiety reduction Protocol And can be classified as:
1- Benzodiazepines
2- Sedatives – Hypnotics
3- Anti-histaminics
All act as Anti-anxiety, anti-convulsant, sedative-hypnotics and skeletal muscle relaxants.
1- Benzodiazepines are a lot: but what are used in dentistry are:
+Diazepam (Valium)
+Chordiazepoxide (Librium)
+Oxazepam (serax)
+Lorazepam (Ativan)
+Flurazepam (Dalman)
2- Sedatives and hypnotics are: Barbiturates and non-Barbiturates.
+Barbiturates are: Pentobarbital, secobarbital, phenobarbital, methohexital.
3- Anti-histaminics are: Benadryl, Phenergan, Atarax & Avil.
Anxiety Reduction Protocol (Most Commonly Used with Oral & Maxillofacial Surgeries):
- Before appointment
• Hypnotic agent to promote sleep on night before surgery (optional)
• Sedative agent to decrease anxiety on morning of surgery (optional)
• Morning appointment and schedule’s so the reception room time is minimized
- During appointment
• Pharmacological means of anxiety control
A- Local anesthetics of sufficient intensity and duration
B- Nitrous oxide
C- Intravenous anxiolytics.
- After Surgery
Dental Work as other medical fields , requiring application of therapeutics to treat, control, prevent, .... etc conditions.
Here, we are going to talk about different medications, drug classifications, doses, side effects, Interactions, brand names, ... etc.
the dental field contains a lot of diseases, Syndromes, Conditions altering the treatment modality and requiring different drugs, so that there are a lot of drugs to the dentist that may prescribe, furthermore, there are a lot of drugs that the dentists should know as they cause conditions in oral cavity, leading to a diagnosis of medical condition in the patient Or even may have interactions with drugs you're welling to prescribe.
Drugs used in dentistry are a lot, simply, can be classified into:
• Medications used to control pain and anxiety
• Analgesics
• Antibiotics
• Anesthetics
• Medications used to treat dental infections
• Antifungals
• Other dental medications
----------------------------------
Chapter One: Medications used to control pain and anxiety
Dental treatment includes pain, In almost all the procedures ex: reduction, cavity preparation, surgery, sublingual scaling, … etc., then, the dentist should be care about this point, because, the dental Client (Patient) who comes to the dental office seeking treatment is almost nearly 90% afraids from what is called a dentist, then it becomes one of the most important success factors of the dentist in his work in the point of view of the patient is feeling comfortable in treatment without pain. AS one of the most reported Complication by clients is PAIN.
Dental Procedures is then accompanied with control of pain and sedation, with different procedures, including psychological control of pain, medication, anesthesia, sedation, Anxiety reduction protocol, and much more.
Here In this article we will discuss those drugs that include control of pain and anxiety, but NOW in this part of the article we will discuss the general view of the next chapters.
Several medications are available to help create more relaxed, comfortable dental visits. Some of the medications make the client feel no pain during the treatment, while the others can make him relax and others make him sleep completely.
----------------------------------
How can we choose the way to control pain and anxiety for the Client?
First of all, the dentist should discuss with the patient the procedures that will be done, the overall health of the client, history of allergies and your anxiety level befor any approach is to be chosen.
----------------------------------
Basics to follow when choosing drug for relieving pain.
Analgesics are the drugs that are used for relieving pain, the Minor dental procedures (Non-surgical) requires a little relieving drugs, so the Non-narcotic are the drugs of choice, while the more invasive surgical procedures including oral and maxillofacial surgeries requires the narcotic analgesics as it works in the CNS (will be discuss later in the Chapter Three).
Before the dental procedure is to take place, the dentist should decide to put the client in the status of “FREE OF PAIN” then the anesthesia should be taken in consideration. The Anesthesia is classified into local and general anesthesia, while most of dental procedures requires the local, then it be used in almost all the cases, but the general anesthesia will be used in Oral and Maxillofacial surgeries, in completely un-cooperative patients or for child patient where the cavity preparation is nearly impossible.
----------------------------------
What is the Anxiety and how it can be controlled?
Anxiety is a psychological and physiological state characterized by somatic, emotional, cognitive, and behavioral components.[2] It is the displeasing feeling of fear and concern. (Wikipedia)
Anxiety can be controlled by the anti-anxiety drugs, such as nitrous oxide, or by sedatives, tranquilizers, Or By Anxiety reduction Protocol And can be classified as:
1- Benzodiazepines
2- Sedatives – Hypnotics
3- Anti-histaminics
All act as Anti-anxiety, anti-convulsant, sedative-hypnotics and skeletal muscle relaxants.
1- Benzodiazepines are a lot: but what are used in dentistry are:
+Diazepam (Valium)
+Chordiazepoxide (Librium)
+Oxazepam (serax)
+Lorazepam (Ativan)
+Flurazepam (Dalman)
2- Sedatives and hypnotics are: Barbiturates and non-Barbiturates.
+Barbiturates are: Pentobarbital, secobarbital, phenobarbital, methohexital.
3- Anti-histaminics are: Benadryl, Phenergan, Atarax & Avil.
Anxiety Reduction Protocol (Most Commonly Used with Oral & Maxillofacial Surgeries):
- Before appointment
• Hypnotic agent to promote sleep on night before surgery (optional)
• Sedative agent to decrease anxiety on morning of surgery (optional)
• Morning appointment and schedule’s so the reception room time is minimized
- During appointment
• Non-pharmacological means of anxiety control
A- Frequent verbal reassurances
B- Distracting conversation
C- No surprises (Clinicians warns patients before doing anything that could cause anxiety)
D- No unnecessary noise
E- Surgical instruments out of patient’s sight
F- Relaxing background music
A- Frequent verbal reassurances
B- Distracting conversation
C- No surprises (Clinicians warns patients before doing anything that could cause anxiety)
D- No unnecessary noise
E- Surgical instruments out of patient’s sight
F- Relaxing background music
• Pharmacological means of anxiety control
A- Local anesthetics of sufficient intensity and duration
B- Nitrous oxide
C- Intravenous anxiolytics.
- After Surgery
• Succinct instructions for postoperative care
• patient information on expected postsurgical sequelae (e.g, swelling or minor oozing of blood)
• Further reassurance
• Effective analgesics
• Patient information on who can be contacted if any problem arise
• Telephone call to patient at home during evening after surgery to check whether any problems exist.
----------------------------------
----------------------------------
----------------------------------
Chapter Two: Analgesics
What are the Analgesics ... ?
The Analgesics are those drugs that elevate the pain threeshold above the subcortical level.
- Analgesics is a british word means painkilling.
What are the Classifications of analgesics:
Narcotics - Non-Narcotics.
----------------------------------
- Non-Narcotic Analgesics are:
A- NSAIDs
B- Anti-Pyretics
A- NSAIDs are :- analgesic, anti-pyretic, Anti-inflammation & Anti-Rheumatics
1- Aspirin( Acetyl Salicylic Acid) Works as Peripheral Vasodilatation and works on hypothalamus to decrease prostaglandin to decrease pain and inflammation.
2- Ibuprofen*
3- Zombirac*
4- Diflunisal* are: Derivative of salicylic Acid
5- Piroxicam*
6- Diclofinac*
* (( Such As NSAIDs in Properties ))
B- Anti-Pyretics is those drugs that acts as analgesics and Antipyretics such as ( Acetaminophen ) and it's an aspirin substitute.
----------------------------------
Narcotic Analgesics: Work on narcotic receptors on CNS.
- Morphine ia the drugs of choice in cases of: Post-operative pain, Accidental pain or traumatic pain.
Examples:
1- Methadone: Adult Dose 2.5-10 mg ( Not For Children under 18 years old )
2- Meperidine: Adult Dose 50-100 mg
3- HydroMorphine: Adult Dose 2 mg ( 8 times more potent than Morphine )
4- Codeine: Adult Dose 15-60 mg ( drug of choice used for cough suppression )
----------------------------------
----------------------------------
----------------------------------
Chapter Three: Antibiotics
1-Prophylactic antibiotics used before dental surgeries.
2-Commonly used antibiotics in dentistry.
3-Dental Concerns for uses of anti-infective agents
- Prophylactic Antibiotics Used Before Dental Surgeries-
* Only In the following conditions, Prophylactics antibiotics are recommended in order to avoid endocarditis
-- Prosthetic cardiac valves (High risk of endocarditis)
-- Surgically constructed pulmonary shunts (High Risk)
-- Previous Bacterial Endocarditis (High Risk)
-- Valvular Dysfunctions (Moderate Risk)
-- Hypertrophic Cardiomyopathy (Moderate Risk)
-- Mitral Valve Prolapse (Moderate Risk)
These Risks In these cases are in those dental procedures:
-- Dental Extractions.
-- Periodontal Surgeries.
-- Implant Procedures.
-- Re-implantaion Of avulsed teeth.
-- Endodontic instrumentation beyond the apex.
-- Subgingival Procedures.
----------------------------------
----------------------------------
----------------------------------
Other Chapters will be prepared and published soon, Keep in touch
Yours,
:: World Of Dentistry :: TEAM
• patient information on expected postsurgical sequelae (e.g, swelling or minor oozing of blood)
• Further reassurance
• Effective analgesics
• Patient information on who can be contacted if any problem arise
• Telephone call to patient at home during evening after surgery to check whether any problems exist.
----------------------------------
----------------------------------
----------------------------------
Chapter Two: Analgesics
What are the Analgesics ... ?
The Analgesics are those drugs that elevate the pain threeshold above the subcortical level.
- Analgesics is a british word means painkilling.
What are the Classifications of analgesics:
Narcotics - Non-Narcotics.
----------------------------------
- Non-Narcotic Analgesics are:
A- NSAIDs
B- Anti-Pyretics
A- NSAIDs are :- analgesic, anti-pyretic, Anti-inflammation & Anti-Rheumatics
1- Aspirin( Acetyl Salicylic Acid) Works as Peripheral Vasodilatation and works on hypothalamus to decrease prostaglandin to decrease pain and inflammation.
2- Ibuprofen*
3- Zombirac*
4- Diflunisal* are: Derivative of salicylic Acid
5- Piroxicam*
6- Diclofinac*
* (( Such As NSAIDs in Properties ))
B- Anti-Pyretics is those drugs that acts as analgesics and Antipyretics such as ( Acetaminophen ) and it's an aspirin substitute.
----------------------------------
Narcotic Analgesics: Work on narcotic receptors on CNS.
- Morphine ia the drugs of choice in cases of: Post-operative pain, Accidental pain or traumatic pain.
Examples:
1- Methadone: Adult Dose 2.5-10 mg ( Not For Children under 18 years old )
2- Meperidine: Adult Dose 50-100 mg
3- HydroMorphine: Adult Dose 2 mg ( 8 times more potent than Morphine )
4- Codeine: Adult Dose 15-60 mg ( drug of choice used for cough suppression )
----------------------------------
----------------------------------
----------------------------------
Chapter Three: Antibiotics
1-Prophylactic antibiotics used before dental surgeries.
2-Commonly used antibiotics in dentistry.
3-Dental Concerns for uses of anti-infective agents
- Prophylactic Antibiotics Used Before Dental Surgeries-
* Only In the following conditions, Prophylactics antibiotics are recommended in order to avoid endocarditis
-- Prosthetic cardiac valves (High risk of endocarditis)
-- Surgically constructed pulmonary shunts (High Risk)
-- Previous Bacterial Endocarditis (High Risk)
-- Valvular Dysfunctions (Moderate Risk)
-- Hypertrophic Cardiomyopathy (Moderate Risk)
-- Mitral Valve Prolapse (Moderate Risk)
These Risks In these cases are in those dental procedures:
-- Dental Extractions.
-- Periodontal Surgeries.
-- Implant Procedures.
-- Re-implantaion Of avulsed teeth.
-- Endodontic instrumentation beyond the apex.
-- Subgingival Procedures.
----------------------------------
----------------------------------
----------------------------------
Other Chapters will be prepared and published soon, Keep in touch
Yours,
:: World Of Dentistry :: TEAM
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