Top medications in dental practice: Dental assisting

As a dental assistant, you'll need to be familiar with the top medications used in dental care, which starts with the basics of pharmacology, the study of how medications work and why they're used.

As you review your patient's medication histories, having a solid understanding of pharmacological principles helps you to understand how some medications can affect your patient during dental procedures, and recognize medication side effects when they occur.

This knowledge also helps you to understand the principles of managing pain and infection, prepares you to respond effectively in emergencies, guides the education you provide for your patients, and helps to keep patients safe.

Now, some of the most common medications you'll see in the dental setting are used to manage pain, prevent or treat infections, and manage anxiety.

Medications used to manage pain are called analgesics, and are categorized as non-opioid or opioid medications. Non-opioid analgesics are used for mild to moderate pain and include acetaminophen and non-steroidal anti-inflammatory drugs known as NSAIDDs, including ibuprofen, naproxen, and aspirin.

These medications are available over the counter without prescription. In contrast, opioid analgesics may be prescribed for moderate to severe pain, often following extensive dental procedures.

However, current guidelines recommend non-narcotic analgesics as first-line therapy before using opioids whenever possible.

When opioids such as codeine combinations are indicated, they must be prescribed by a licensed provider. Because these medications carry a risk of addiction and adverse effects, dentists take special care to prescribe them only when necessary, and when non-opioid analgesics are not effective.

Other medications commonly used in the dental setting are antibiotics. These medications are most often used to treat bacterial infections, such as abscesses and gingival infections.

Other times, antibiotics are given to prevent infections that could occur after a dental procedure, a practice known as antibiotic prophylaxis.

This is especially important for patients with certain conditions, like prosthetic joints, infective endocarditis, and prosthetic heart valves.

Antibiotics can be bactericidal, which means they directly kill harmful bacteria, or bacteriostatic, meaning they weaken the bacteria by inhibiting their growth and reproduction, so the immune system can eliminate them.

One of the most common antibiotics you'll see in the dental setting is penicillin. For patients who are allergic to penicillin, alternatives such as azithromycin or certain cephalosporins may be prescribed, depending on the severity of the allergy.

Anti-fungal medications are used for patients diagnosed with a fungal infection, which can occur in those who are immunocompromised, have a condition that causes a dry mouth or xerostomia, and those who have poorly fitting dentures.

The anti-fungal medication used most often in dental settings is nystatin. Other common medications you'll see in the dental setting include antiviral medications like acyclovir to manage viral infections that affect the mouth, such as herpes simplex virus, and anti-anxiety medications like diazepam, which are used to help patients feel calmer and more comfortable during complicated dental procedures.

Now, the patients who are seen in your dental office are often prescribed a variety of medications to treat medical conditions.

As a dental assistant, you need to be familiar with some of these medications, how they're used, and how they affect dental care.

Cardiovascular medications are used to treat a wide range of conditions affecting the heart and circulatory system. Some of these medications, like the beta-blocker metoprolol, can lower your patient's BP and heart rate, so keep this in mind when taking their vital signs.

Anticoagulants like warfarin help prevent blood clot formation, so be aware that bleeding might last longer after certain procedures.

Lastly, diuretics like hydrochlorothiazide are used to manage fluids in the body, which can contribute to dry mouth, potentially increasing the risk of dental disease.

Another medication to be aware of is phenytoin, a neurologic medication used to control seizures. Fenytoin can cause overgrowth of the gingiva, which makes it easier for dental plaque to accumulate.

Knowing this side effect will prompt you to teach your patient about the importance of meticulous oral hygiene, and prepare you to assist the dental team with enhanced care measures to control dental disease as needed.

Lastly, be sure to take note if your patient is prescribed a medication to help control their blood glucose, like insulin.

You'll need to watch these patients closely for signs of low blood glucose during dental procedures, like sudden dizziness, sweating, or trembling.

Also, be sure to encourage your patients with diabetes to closely monitor their blood glucose after they leave your dental office.

As a dental assistant, you'll also need to recognize when your patient is experiencing a negative response to a medication known as an adverse effect.

These can include allergic reactions that happen when the medication triggers an immune response, which can range from a mild rash or itching to a life-threatening emergency like anaphylactic shock.

Gastrointestinal reactions like nausea and vomiting, xerostomia and mouth sores, and oral fungal infections. Other possible adverse effects to keep in mind include toxicity, which happens when a medication causes cellular harm, tolerance when a medication loses its intended effect over time, and addiction when a patient becomes physically dependent on a medication like opioid analgesics.

Lastly, medication interactions can happen when a patient is taking multiple medications and can range from mild to severe.

As a dental assistant, you'll need to carefully review your patient's medical history and ensure it's up to date as you talk to patients and document their information in the dental record.

While you don't prescribe medications and can't sign or call in prescriptions, you can dispense medications under direct supervision of a dentist.

You can also support medication safety by using a current medication reference to learn about the medications your patients are prescribed.

Ensuring all medications used in your dental office are labeled, secured, and disposed of properly. And keeping prescription pads secure under lock and key.

Finally, you'll provide education when patients start new medications in the dental office. All right, as a quick recap.

As a dental assistant, being familiar with the top medications used in dental care helps you to understand how some medications can affect your patient during dental procedures, and recognize medication side effects when they occur.

This knowledge also helps you to understand the principles of managing pain and infection, prepares you to respond effectively in emergencies, guides the education you provide for your patients, and helps to keep patients safe.