Important Information

Every Dental 
Patient Should Know

Because the work performed by your dentist is mostly in or about the oral cavity, many patients assume incorrectly that other medical conditions -as well as medications- even apparently harmless ones purchased over the counter- are inconsequential. This is not so. It is estimated that between 25 and 50% of all emergency room admissions are in some way related to drug interactions.
The following is a partial list of potential problems which can occur if your dentist is not provided with all the information necessary to make proper medical/dental decisions:


These otherwise useful and commonly used antihistamines are incompatible with certain antibiotics which your dentist may prescribe. These include Erythromycin, EES, Erythrocin, E-mycin, Ketoconazole and Itraconazole (antifungal agents). Worst case scenario: death. Be sure to include all mediation you are taking on your medical history (which you can down load from this program).

Important: Consult with your Pharmacist each and every time you change or are given new medications.-Your Pharmacist knows more about his topic than any other healthcare professional.
Penicillin Allergy
You may have been told at one time or another to avoid the use of penicillin. You should also be aware that Keflex (cephalo- sporin), has a cross allerginicity with penicillin. 5-16% of people with penicillin allergy will also be allergic to these antibiotics. Once again, there are good substitutes, so don't take chances.

MAO Inhibitors/Antidepressants
Some antidepressants are classified as "MAO (mono amine oxidase) inhibitors" and a percentage of the US population is on them. They are sold under the names Nardil (Phenelzine) and Parnate (Trienlcypromine). When used with alcohol, cheese and dairy products, over-the-counter decongestants and other antidepresants, they can cause problems ranging from illness to death.

Okay. So you don't want to tell your dentist or MD that you're using cocaine. You get a shot of local anesthetic and your heart stops. Your health care provider is probably safe if you "forgot" to mention it on your medical history. But. . . you are not. Decisions, decisions. If you are proud (and foolish) enough to use it, be prepared for the consequences if you fail to mention it.



Do You Buy Mail Order Drugs?
This may save you a few bucks. But . . . it also leaves you vulnerable to other problems, including lack of guidance and counseling regarding drug interactions. If you think this really does save money, think again. One major cause of emergency room admissions is undesirable drug interactions.


Heart Disease/High Blood Pressure

Blood Pressure
    As part of his or her service, your dentist may take your blood pressure at your initial appointment - especially if you are "at risk". Taking your blood pressure has two important functions: For example, the most commonly used local anesthetics contain vasoconstrictors (epinephrine, neo-cobefrin) which can increase your blood pressure. These medications are used primarily to prolong the effect of the anesthetic. However, other medications can be substituted in the event that your blood pressure is too high.
How High is "TOO HIGH"?
As a rull of thumb, if your systolic pressure (the top number ) is over 140, and your diastolic pressure (the bottom number) is over 90 you are considered "at risk". However, other factors - including the difference between the top and bottom (diastolic) pressure are also important.

Heart Disease



If you have a history of certain types of heart disease and/or have had open heart or bypass surgery or a heart implant or a history of valve problems, your dentist will (must) follow the guidelines of the American Heart Association and pre-medicate you before any invasive procedures including injections and prophylaxis (cleaning) are undertaken. Any technique, however simple, which allows bacteria and other organisms to enter the blood stream could result in a condition called Subacute Bacterial Endocarditis ("SBE") - a vegetative growth on one of the heart valves. Taking a large dose of antibiotics before treatment can prevent this problem. Do not, however, attempt to pre-medicate yourself without first talking with the dentist.

Your dentist may have a very useful device called an ELECTROSURG which he or she may use to remove excessive gum tissue. It's safe, painless (you should be numb) and very beneficial UNLESS you have a PACEMAKER-in which case you may be short circuited! Once again, COMPLETE YOUR MEDICAL/DENTAL HISTORIES ACCURATELY!

Implants (Knee, hip, other joint)
Equally important in the use of premedication (antibiotics) is a history of implants. The same guidelines for heart conditions mentioned above are used for these devices.



Ten years ago this nation was shocked by the news that a Florida dentist had infected patients with HIV he was carrying. After years of investigation, it was determined that any such infection most likely did not happen as the result of routine dental treatment. It is now suspected that, if the dentist did indeed infect anyone, it was intentional. The rebuttals, of course, did not get the headlines which the original claims did. Thus, some people still avoid dental care or are frightened as a result.
Since that time, more than 4 billion incidences of dental treatment have been performed in the US alone - without a single instance of a patient having contracted HIV from a dentist/dental procedure.



Health care professionals have, however, not been so fortunate. More than 200 physicians, dentists, nurses, assistants, hygienists, lab techs, and EMS technicians have been inoculated by HIV positive patients in the line of duty.

One figure which is not known is the number of people whose health was impaired as a result of not seeking help for dental conditions because of the scare tactics proffered by the news media, federal government, and concerned but uninformed citizen groups. The one good result of all this is that it is now safer than ever to receive dental treatment. If you have concerns, its quite alright to ask your dentist about his or her sterilization routine, even to have a tour of their autoclave. (If they don't have an autoclave, go someplace else!)


There is no problem receiving dental care when you are pregnant provided 1) you have not been advised otherwise by your doctor and 2) certain precautions are taken during your treatment. There are several of the latter of which you should be aware. EPINEPHRINE- the same medication found in local anesthetics mentioned above- has been suspected -but not proven- of causing miscarriages. So has the use of NITROUS OXIDE. There are other substitutes so. . . why take chances?

When to see your dentist
The first tri-mester is the period when the majority of fetal development takes place. It is, therefore, the best time to avoid drugs, radiation, and long dental sessions. In the event, however, that you have an abscess, it will be necessary to have treatment. The abscess itself could well be far more detrimental to the developing fetus than anything your dentist will give you. The same applies to poor nutrition and the use of drugs and alcohol during pregnancy. For example, one of the major causes of birth defects is the lack ofFOLIC ACID. If, therefore, you are of childbearing age, it is imperative that you follow these precautions. Your dentist can help council you regarding proper nutrition which will not only help your baby achieve strong teeth and bones but also prevent undesirable side effects as well. One other drug which you should avoid during pregnancy isTETRACYCLINE (Vibramycin, Doxycycline, Achromycin). These drugs aren't dangerous (unless you are allergic to them) but could cause your baby's teeth to stain.

Other Drug Interactions
The scope of this discussion is limited. However, there are many other possible drug interactions which are potentially harmful. Therefore, IT IS IMPERATIVE THAT YOU WORK CLOSELY WITH ALL OF YOUR HEALTH CARE PROVIDERS - AND ESPECIALLY YOUR LOCAL PHARMACIST. LIST ALL YOUR MEDICATIONS - LEGAL OR OTHERWISE- TO INSURE YOUR SAFETY. A good source to find out more about these drug incompatibilities is USPDI or Facts & Comparisons.

Accurate Information
All of these potential problems as well as other less common ones- can be prevented simply by providing your dentist with the proper information.



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