Why must you know about your patients’ pharmacological history?

By Drs. Jacob Fitzgerald, Joel Epstein, Mark Donaldson, Karen Fung, Gordon Schwartz, Cameron Jones

Classes of medications reported by patients (PDF)

There are many reasons why we need to be aware of the medications that our patients are taking.

We need to make sure that there are no adverse reactions to these medications with the treatments or drugs that we prescribe. Additionally, we need to have an understanding of the effects these medications on the oral environment. Importantly, knowing exactly what a patient takes can also provide insight into their medical conditions. Some medications have oral side effects upon saliva, mucosa and potentially increase risk of negative oral health and systemic health implications.

In our periodontal practice, we have noted a significant number of patients taking medications and increasingly multiple ones. Not only has there been continuous development of new medications that we must now learn about, but also and increased use by the public of over-the-counter medications, herbs, and nutritional supplements that may potentially interact with prescription medications and may consequently have inherent effect on the patient’s oral status. As periodontists, we tend to see patients that are older, with an increased chance that they are taking at least one medication.

In order to get a sense of how much medication use we encounter, we decided to do a chart audit of 240 consecutive patients. We enumerated and categorized the medications that these patients are taking in a table that allowed us to have a clearer view of how much and which medications we come across. 

We found that 161 of our 240 consecutive patients were taking some form of medication. As a group, these 161 patients were taking 140 different medications with an average 2.6 drugs per patient. We will be presenting the details of the types of medications when we publish the data in a more formalized format. 

Although the median age of our patient population is likely older than in most GP practices, we feel that our findings are relevant to most dentists who treat adults. We think that the increased prevalence and variety of medications in our population highlights the need to preform adequate medical histories and to have the required knowledge base to understand our patients’ pharmacological history.

There is potentially some bias in our patient population as certain medications can cause gingival overgrowth, which would result in a disproportionate number of these patients being seen. This was not the case, as there were just two prescriptions that could have caused this.  

Do you have any particular question on this topic? Do you have any comments or suggestions? Email us at oasisdiscussions@cda-adc.ca

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