oral diseases and drugs in dentistry

drugs in dentistry
1. storage of drugs in the dental setting should be controlled by following the standard operation procedures (SOP) drugs are usually held under lock and key until needed, as long as a practitioner is present drugs may stay in a treatment room. all drugs should be stored according to the manufacturer's guidelines.
2. main classes of drugs include Analgesics used to relieve pain treatment is usually required too in order to eliminate pain completely. Antibiotics are used to fight bacterial infections commonly used include: amoxicillin penicillin and metronidazole sedatives can also be used to creat a calm state of consciousness so a nervous patient is able to tolerate dental treatment.
3. emergency drugs are regulary checked and maintained.: oxygen, salbutamol, adrenaline, hydrocortisone, chlorphenamine, midazolam, glucose, GTN spray and asprin
medical conditions that affect oral tissues
1. Oral Candidiasis (oral thrush) HIV sufferes frequently develop oral candadidasis, thrush can take several different forms this condition is characterized by generally white patches that can be wiped off sometimes mistaken for Materia Alba. under the white patches there could be red sores which can be very painful. treatment of anti fungal medicines should be taken
2. eating disorders are accociated with general ill health and acid erosion of enamel. ill health leads to a weak immune system which can lead to ulcer breakouts of the oral cavity.
3. Glossitis is sorness and inflamation of the tongue. people who suffer from hormone disturbances and anaemia may also develop glossitis. associated with a smooth glazed appearance of the normally thick layer of mucosa membrane on the upper surface
4. Ptyalism is the excessive secretion of saliva cause by an underlying disease and can occur due to: periodontal disease, oral soft tissue trauma, conditions causing acid reflux, nervous system disorders (Parkinsons ect) mercery poisoning
5. Diabetes suffers generally have poor wound healing and are prone to post-op complications and oral infection
6. oral cancer can effect all areas of the mouth including soft tissues jaw bones and salivary glands 90% of oral cancer begins in soft tissues initiailly as a lesion called SCC (squarmous cells carcinoma. signs include a painless ulcer that doesnt heal with in 2-3 weeks usually found on the floor of the mouth and inside of cheeks. presented as a white or red patch. surgical treatment is usually required
7. hepatitis suffers are thought to be prone to tooth decay and have an increased likely-hood of xerostomia, tooth sensitivity, gum infections and mouth ulcerations due to these problems suffers quality of life is reduced.
8. epilepsy sufferers can be perscribed a drug called Epanutin which can cause gingivaltissues to overgrow (Gingival hyperplasia) making oral hygiene levels harder to maintain.
9. mental illness, people with various serious mental illnesses can lead to poor dental hygiene as it is not seen as a priority lack of motivation and self-neglect. medicines used can also decreas salivary flow leading to caries.
10. HIV and the medication taken by people who are HIV positive can cause a decrease in salivary flow leading to a dry mouth known to increase caries Necrotizing ulcerative periodontitis (NUP) previously called HIV-periodontitis a condition associated with rapid bone and soft tissue loss leading to bine exposure and tooth loss bleeding and pain can sometimes be present.
11. Xerostomia - dry mouth can cause chewing speaking and swallowing very difficult and can lead to: a burning sensation in the mouth, tooth decay, bad breath gum disease infections in the mouth
12. herpes simplex is a common infection involving the oral mucosa or lips. the infection can be very painful or barely noticeable. when very painful eating and drinking can be very uncomfortable. this infection can reoccur effecting the quality of life and the persons appearance.
13. Oral leukoplakia and Erythroplakia is the presence of premaligant squarmous lesions - areas of altered epithelium that are at a risk of SCC Leukoplakia is described as a white lesion of the oral mucosa that cannot be scraped off it is usually found on the outside edges of the tongue lesions normally have an uneven surface with hair like projections. Erythroplakia - a red patch that cannot be accounted for by any other disease and behaves in the same way as the Leukoplakia
14. Varicella Zoster virus (chicken pox) and Herpes Zoster virus (shingles) chicken pox is presented as an itchy rash on the body which can also be present in the mouth as sores. it can be very uncomfortable and can oral hygine distressing due t the pain that may be involved. shingles is just like chicken pox however usually only affects one area of the body.
15. Lichen planus is an ongoing inflamation of the mucosa membranes inside the mouth. it may appear as white lacy patches red swallen tissues or open sores burning pain is occasionally presentin the cheeks tongue or gums. there is not normally pain present but some areas can blister making tem sensitive to spicy cold or hot foods.
16. osteoporosis effects the bones making them become less dense and more likely to fracture. if the jaw bones become affected by osteoporosis tooth loss is very common and other dental issues may occur.
17. Ageing on oral tissues: skin-less fat/elasticity Bone-brittle Oral Mucosa-thin less elastic, less tolerant to dentures, gingival recession increased risk of root caries. Salivary glands-less production of saliva teeth-darker,pulpchamber reduced more narrow reduced sensitivity
Prevention, diagnosis&managment
1. diagnosis- regular dental check up appointments means early stages of any serious condition can be spotted and referrals can be sent at the right time for further investigation. Biopsy of a suspectedsite can be taken in order to gain an accurate diagnosis.
2. regular check ups - early detection of caries and lesions can maintain a healthy oral cavity. healthy diets including low red meat intake has been know to reduce oral cancer risks.
3. smoking can lead to gum disease, tooth loss, cancer and tooth staining. chewing tabacco is known to cause cancer in the mouth at a much higher rate than smoking. alcohol can cause oral cancer and can contribute to acid erosion to the tooths enamel
4. management- check ups medication and surgery are all parts of the management system. depending on the type of cancer and patient some of these things may not apply. surgery and medicines are usually prescribed by the oncologist. patients should be dealt with sensitively when discussing treatment and diagnosis of oral diseases and cancers.
medical conditions and treatment planning
1. Warfarin users blood clotting ability is decreases so prior to any dental treatment that mat cause bleeding the patient would need to have an INR reading ( a blood test to check the clotting ability) as bleeding is very hard to stop for anyone taking this medication their INR must be below 3.0
2. Pregnancy will prevent the use of amalgum and xrays due to the hazards of mercery and radiation for the baby.
3. Pacemakers can be interfered with by old style scalers so it is much safer to use a hand scaler for someone who has a pacemaker.
4. Cancer can effect treatment planning as the patient can ony have dental treatment during certain times of their cancer treatment. patients receiving cancer treatment generally have a weakened immune system so bleeding and infection is much more common the dentist and Oncologist should plan treatment together.
5. osteoporosis can affect the jaw which could lead to jaw fracturs during treatment PT may be refered to a specialist. the condition should be taken into consideration when positioning the dental chair.
6. Oral Thrush - the patient would be prescribed an anti-fungal medicine to clear up the infection, once the infection has gone treatment can begin.
7. Chicken pox- the patient should rebook appointment as it is highly infectious in its early stages.
8. herpes simplex, if a patient has a herpes outbreak their treatment must be rebooked and cancelled

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oral diseases and drugs in dentistry

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	Created by zoelynch about 9 years ago