Medications used in dentistry and periodontics

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In periodontics, there are four reasons to seek medication. Those four reasons include infection, swelling, pain, and sedation. Although some patients may experience pain, swelling, and infection as a result of an acute periodontal problem such as advanced periodontal disease, periodontic patients usually do not need medication until they are faced with surgery. For successful surgery, medication is then introduced prior to the operation, usually the morning before the procedure and is continued for up to two weeks after.

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Conscious sedation in dentistry

During the surgery, dentists use medication to not only ease the pain of the procedure, but also to reduce patient anxiety. With conscious sedation, you remain comfortable and pain-free. The term "medication dentistry" is also referred to as anxiety-free dentistry, relaxation dentistry or comfortable dentistry. This is because most of the patients have feelings of anxiety during even a routine trip to the dentist's office.

There are a number of sedation drugs, which can be taken by mouth. They have been developed specifically for the purpose of conscious sedation in dentistry. Sleep dentistry is a common term once used to describe a visit to the dentist. The interesting thing is that though it was referred to as sleep dentistry, the patient never actually went to sleep during the visit. Sleep dentistry should really be applied to dentistry which uses the aid of general anesthesia. The dentist will determine which medication is best used during sedation. [1]

Diazepam

This is probably the most well recognized drug used today. Diazepam (Valium) has been used since the 1960s. It is a well-known sedative. It is extremely useful during appointments where the most extensive dentistry is being performed.

Triazolam

Triazolam (Halcion) is the most well-known treatment for insomnia. It is a highly effective drug, which can be used in conjunction with an antihistamine. It is similar to diazepam and is a popular choice for many different dentists. Triazolam is typically used for shorter appointments.

Zaleplon

Zaleplon (Sonata) is also used in the treatment of insomnia. The patient is not in an extended sleep during throughout oral sedation, but is rather relaxed and comfortable throughout the procedure.

Lorazepam

Lorazepam (Ativan) is a very commonly prescribed drug for anxiety. It is very useful in appointments that are longer than two hours.

Hydroxyzine

Hydroxyzine (Vistaril) is classified as an antihistamine. It has anti-anxiety effects and works in conjunction with many benzodiazepines. It has no amnesic properties.

Midazolam

Midazolam the shortest half-life of any available drugs. It is ideal for short appointments and simple procedures. It has many anti-anxiety properties as well as amnesic properties.

General medication information

Medications are typically used to control pain and anxiety in dentistry. The patient is very rarely out completely during a dental procedure, even if he or she cannot accurately remember the procedure upon waking up.

Anti-inflammatory

Anti-inflammatory medications are used to relieve discomfort and redness of the mouth and gums. They are available by prescription only and are available as pastes under some brand names such as Kenalog and Orabase. There are also non-prescription anti-inflammatory medications, such as Motrin, which may be used to relieve pain and are available over-the-counter.

Anesthesia

Local anesthesia, general anesthesia, nitrous oxide and intravenous sedation are all used during common procedures to help dull and control pain and anxiety.

Topical anesthetic agents are typically intraorally to control pain or irritation caused by toothache, teething, or sores in or around the mouth. Topical anesthetics are available by prescription or over-the-counter. They are available in sprays, dental paste, dental gels, lozenges, ointments and solutions. Anbesol, Chloraseptic, Orajel and Xylocaine are examples of available anesthetics over-the-counter. Some medications are also given in order to control plaque and gingivitis. This type of medication is typically available in a mouthwash.

Antiseptics

Antiseptics may be recommended (over-the-counter) by the dentist to help reduce plaque and gingivitis buildup, as well as kill germs, which may be the cause of bad breath.

Knowing the role of supragingival plaque in the initiation of periodontal disease and insufficient control of the plate, the use of antiseptics is warranted. These anti-plaque derived from different chemical classes and have different mechanisms of action.

Other medications

There are also many medications, which are used to treat tooth decay. Fluoride is used to prevent tooth decay in individuals. Fluoride is available in non-prescription form and is available in many different types of toothpaste.

Muscle relaxants and antifungal medication is also sometimes prescribed within dentistry. Muscle relaxants may be prescribed in order to reduce the patient's stress levels and/or to help the patient discontinue grinding their teeth. It can also be used to treat TMJ disorders.

Antifungal medication may be used to treat oral thrush, which is common in infants. The goal of treatment is stop the spreading of the Candida fungal infection.

Related Research Articles

<span class="mw-page-title-main">Anesthesia</span> State of medically-controlled temporary loss of sensation or awareness

Anesthesia or anaesthesia is a state of controlled, temporary loss of sensation or awareness that is induced for medical or veterinary purposes. It may include some or all of analgesia, paralysis, amnesia, and unconsciousness. An individual under the effects of anesthetic drugs is referred to as being anesthetized.

<span class="mw-page-title-main">Local anesthetic</span> Medications to reversibly block pain

A local anesthetic (LA) is a medication that causes absence of all sensation in a specific body part without loss of consciousness, providing local anesthesia, as opposed to a general anesthetic, which eliminates all sensation in the entire body and causes unconsciousness. Local anesthetics are most commonly used to eliminate pain during or after surgery. When it is used on specific nerve pathways, paralysis also can be induced.

Sedation is the reduction of irritability or agitation by administration of sedative drugs, generally to facilitate a medical procedure or diagnostic procedure. Examples of drugs which can be used for sedation include isoflurane, diethyl ether, propofol, etomidate, ketamine, pentobarbital, lorazepam and midazolam.

<span class="mw-page-title-main">Dentist</span> Health care occupations caring for the mouth and teeth

A dentist, also known as a dental surgeon, is a health care professional who specializes in dentistry, the branch of medicine focused on the teeth, gums, and mouth. The dentist's supporting team aids in providing oral health services. The dental team includes dental assistants, dental hygienists, dental technicians, and sometimes dental therapists.

<span class="mw-page-title-main">Triazolam</span> Triazolobenzodiazepine class medication

Triazolam, sold under the brand name Halcion among others, is a central nervous system (CNS) depressant tranquilizer of the triazolobenzodiazepine (TBZD) class, which are benzodiazepine (BZD) derivatives. It possesses pharmacological properties similar to those of other benzodiazepines, but it is generally only used as a sedative to treat severe insomnia. In addition to the hypnotic properties, triazolam's amnesic, anxiolytic, sedative, anticonvulsant, and muscle relaxant properties are pronounced as well.

<span class="mw-page-title-main">Anesthetic</span> Drug that causes anesthesia

An anesthetic or anaesthetic is a drug used to induce anesthesia ⁠— ⁠in other words, to result in a temporary loss of sensation or awareness. They may be divided into two broad classes: general anesthetics, which result in a reversible loss of consciousness, and local anesthetics, which cause a reversible loss of sensation for a limited region of the body without necessarily affecting consciousness.

Periodontology or periodontics is the specialty of dentistry that studies supporting structures of teeth, as well as diseases and conditions that affect them. The supporting tissues are known as the periodontium, which includes the gingiva (gums), alveolar bone, cementum, and the periodontal ligament. A periodontist is a dentist that specializes in the prevention, diagnosis and treatment of periodontal disease and in the placement of dental implants.

<span class="mw-page-title-main">Gingival recession</span> Exposure in the roots of the teeth

Gingival recession, also known as gum recession and receding gums, is the exposure in the roots of the teeth caused by a loss of gum tissue and/or retraction of the gingival margin from the crown of the teeth. Gum recession is a common problem in adults over the age of 40, but it may also occur starting in adolescence, or around the age of 10. It may exist with or without concomitant decrease in crown-to-root ratio. 85% of the world population has gingival recession on at least one tooth with denuded root surface ≥1.0 mm.

<span class="mw-page-title-main">Dental instrument</span> Tools of the dental profession

Dental instruments are tools that dental professionals use to provide dental treatment. They include tools to examine, manipulate, treat, restore, and remove teeth and surrounding oral structures.

<span class="mw-page-title-main">Scaling and root planing</span> Dental procedure

Scaling and root planing, also known as conventional periodontal therapy, non-surgical periodontal therapy or deep cleaning, is a procedure involving removal of dental plaque and calculus and then smoothing, or planing, of the (exposed) surfaces of the roots, removing cementum or dentine that is impregnated with calculus, toxins, or microorganisms, the agents that cause inflammation. It is a part of non-surgical periodontal therapy. This helps to establish a periodontium that is in remission of periodontal disease. Periodontal scalers and periodontal curettes are some of the tools involved.

Veterinary anesthesia is a specialization in the veterinary medicine field dedicated to the proper administration of anesthetic agents to non-human animals to control their consciousness during procedures. A veterinarian or a Registered Veterinary Technician administers these drugs to minimize stress, destructive behavior, and the threat of injury to both the patient and the doctor. The duration of the anesthesia process goes from the time before an animal leaves for the visit to the time after the animal reaches home after the visit, meaning it includes care from both the owner and the veterinary staff. Generally, anesthesia is used for a wider range of circumstances in animals than in people not only due to their inability to cooperate with certain diagnostic or therapeutic procedures, but also due to their species, breed, size, and corresponding anatomy. Veterinary anesthesia includes anesthesia of the major species: dogs, cats, horses, cattle, sheep, goats, and pigs, as well as all other animals requiring veterinary care such as birds, pocket pets, and wildlife.

Dental anesthesia is the application of anesthesia to dentistry. It includes local anesthetics, sedation, and general anesthesia.

<span class="mw-page-title-main">Dental fear</span> Medical condition

Dental fear, or dentophobia, is a normal emotional reaction to one or more specific threatening stimuli in the dental situation. However, dental anxiety is indicative of a state of apprehension that something dreadful is going to happen in relation to dental treatment, and it is usually coupled with a sense of losing control. Similarly, dental phobia denotes a severe type of dental anxiety, and is characterised by marked and persistent anxiety in relation to either clearly discernible situations or objects or to the dental setting in general. The term ‘dental fear and anxiety’ (DFA) is often used to refer to strong negative feelings associated with dental treatment among children, adolescents and adults, whether or not the criteria for a diagnosis of dental phobia are met. Dental phobia can include fear of dental procedures, dental environment or setting, fear of dental instruments or fear of the dentist as a person. People with dental phobia often avoid the dentist and neglect oral health, which may lead to painful dental problems and ultimately force a visit to the dentist. The emergency nature of this appointment may serve to worsen the phobia. This phenomenon may also be called the cycle of dental fear. Dental anxiety typically starts in childhood. There is the potential for this to place strains on relationships and negatively impact on employment.

<span class="mw-page-title-main">Gingivitis</span> Inflammation of the gums

Gingivitis is a non-destructive disease that causes inflammation of the gums; ulitis is an alternative term. The most common form of gingivitis, and the most common form of periodontal disease overall, is in response to bacterial biofilms that are attached to tooth surfaces, termed plaque-induced gingivitis. Most forms of gingivitis are plaque-induced.

Special needs dentistry, also known as special care dentistry, is a dental specialty that deals with the oral health problems of geriatric patients, patients with intellectual disabilities, and patients with other medical, physical, or psychiatric issues.

<span class="mw-page-title-main">Twilight anesthesia</span> Anesthetic technique

Twilight anesthesia is an anesthetic technique where a mild dose of sedation is applied to induce anxiolysis, hypnosis, and anterograde amnesia. The patient is not unconscious, but sedated. During surgery or other medical procedures, the patient is under what is known as a "twilight state", where the patient is relaxed and "sleepy", able to follow simple directions by the doctor, and is responsive. Generally, twilight anesthesia causes the patient to forget the surgery and the time right after. It is used for a variety of surgical procedures and for various reasons. Just like regular anesthesia, twilight anesthesia is designed to help a patient feel more comfortable and to minimize pain associated with the procedure being performed and to allow the medical practitioner to practice without interruptions.

Sedation dentistry refers to the use of pharmacological agents to induce relaxation and often sleep in a patient prior to and during a dental appointment. The pharmacological agents used differ depending on patient, level of sedation desired and medical professional administering the sedation medications. The medications can belong to a class of drugs called sedatives, which exert their action by depressing the central nervous system, specifically those areas concerned with conscious awareness. Medications used to obtain sedation often include a benzodiazepine, opioids, dissociative and anti-histamines.

Oral sedation dentistry is a medical procedure involving the administration of sedative drugs via an oral route, generally to facilitate a dental procedure and reduce patients anxiety related to the experience. Oral sedation is one of the available methods of conscious sedation dentistry, along with inhalation sedation and conscious intravenous sedation. Benzodiazepines are commonly used, specifically triazolam. Triazolam is commonly selected for its rapid onset and limited duration of effect. An initial dose is usually taken approximately one hour before the dental appointment. Treatment may include additional dosing on the night proceeding the procedure, to mitigate anxiety-related insomnia. The procedure is generally recognized as safe, with the effective dosages being below levels sufficient to impair breathing.

In the United States and Canada, there are twelve recognized dental specialties in which some dentists choose to train and practice, in addition to or instead of general dentistry. In the United Kingdom and Australia, there are thirteen.

The American Dental Society of Anesthesiology (ADSA) is an American professional association established in 1953 and based in Chicago.

References

  1. "Dental Implants Periodontist". May 2019. Wednesday, 23 June 2021