Dental Practice - Drugs and Problems PDF

Drugs and some related problems in dental practice Dry mouth (xerostomia) Teeth discoloration Dental caries  Dry mouth (xerostomia) You have three pairs of major salivary glands ( parotid, sublingual and submandibular). Each gland has its own tube (duct) leading from the gland to the...

Drugs and some related problems in dental practice Dry mouth (xerostomia) Teeth discoloration Dental caries  Dry mouth (xerostomia) You have three pairs of major salivary glands ( parotid, sublingual and submandibular). Each gland has its own tube (duct) leading from the gland to the mouth.  Dry mouth ( xerostomia)  Saliva protects the teeth against decay , regulating mouth PH and diluting the acids produced by dental plaque bacteria which increase the risk of teeth decay.  Xerostomia Causes: Reduced salivary flow which may result from:  drug therapy mechanical block dehydration  infection of salivary glands DM, anemia, radiation.  Drugs caused dry mouth: Anticholinergic e.g. atropine Sympathomimetics e.g. pseudoephiderine used as decongestant in common cold Antihistaminics e.g. diphenhydramine Analgesics : NSAIDs Diuretics as furosemide  Clinical appearance: The tissue may be dry, pale, atrophic. The tongue may be devoid of papillae, atrophic, fissured.  Multiple carious lesions may be present, Treatment: 1- Saliva substitutes: Sodium carboxymethyl cellulose 0.5% aqueous solution. 2- Saliva stimulants: a- Chewing sugarless gum and sucking sugarless mints are conservative methods to temporarily stimulate saliva flow in patients. b- Pilocarpine solution or tab. c- Bethanechol 3- Caries prevention: fluoride gel (Apply to teeth daily. Do not swallow gel.  / Teeth discoloration Teeth discoloration Causes: 1- Foods and drinks: coffee, tea, colas, certain fruits and vegetables e.g. apples and potatoes 2- Smoking 3- Poor dental hygiene. 4- Environmental: excessive fluoride either from environmental sources (natural high fluoride levels in water) or excessive use ( toothpaste) 5- Old age: removal of the outer layer of enemal revealing the natural yellow color of dentin. 7-Medications: a- Tetracycline and doxycycline (causes teeth discoloration if given before the age of 8). b- Mouth rinses and washes contain chlorhexidine c- Dental materials as silver sulfide-containing materials can cast a gray-black color to teeth. Prophylaxis: a- Lifestyle change: quitting smoking & stop drinking coffee. b- Improve dental hygiene by frequent brushing , cleaning teeth by a dental hygienist every 6 months Treatment - Veneers - Using over-the-counter whitening agents. Dental caries 4- Fluorides Mechanism of action of Fluorides: It is concentrated in bacterial plaque inhibiting bacterial enzymes which produce lactic acid Thus preventing acid decalcification of the tooth structure Administration of fluoride: Thank you