Mrs. Leslie Rudolph

Now I am seeing patients who are open about Medical Marijuana and taking it does that interact as well with drugs?

Ann Eshenaur Spolarich RDH, PhD, FSCDH, Professor and Assistant Dean for Research, Arizona School of Dentistry & Oral Health, A.T. Still University

Hi Leslie Yes - marijuana can interact with other medications - primarily due to CNS effects. Marijuana can also cause tachycardia, which is problematic for patients with CV disease. The challenge that we have is that it is difficult to study due to regulations (as a controlled substance, there are federal funding restrictions around supporting research studies) and because there is so much variation in these products (there are many cannabinoids, and the proportion of each is not known in any given product).

B. W.

Do you caution those who have had a recent RX change to hold off from dental appt/ procedure until feels stabile on new med... (i.e. removed from one or 2 Rx and changed to 1 RX - like amilodipine and metoprolol to ceravedil

Ann Eshenaur Spolarich RDH, PhD, FSCDH, Professor and Assistant Dean for Research, Arizona School of Dentistry & Oral Health, A.T. Still University

This is a great question - and for me, it would depend upon the reason for the change/switch in medications. For example, was the patient switched to other medications because of difficulty in getting BP under control? In that case, I might wait until the cardiologist is comfortable with the patient's response to treatment. If the patient switched because they didn't like the side effects and is otherwise stable, then I probably wouldn't wait. Remember: there are likely other cardiovascular conditions going on at the same time which often weighs in when CV drugs are switched. I would also advise getting a medical consultation to see how the patient is responding to their new treatment regimen.

A. W.

how do you respond to patients that believe we as hygienists dont need to be made aware of current medications they are on

Ann Eshenaur Spolarich RDH, PhD, FSCDH, Professor and Assistant Dean for Research, Arizona School of Dentistry & Oral Health, A.T. Still University

A great question! I always remind patients that their mouths are connected to their body, and that we take the responsibility of ensuring their safety and well-being as priority over any other needs or concerns. I then mention that many of the medications that we administer as part of dental treatment can interact with commonly prescribed medications which is one of the reasons why we ask about medication history. Also, we want to be sure that the patient is medically stable enough to undergo dental treatment. Give this a try - good luck!

Mrs. Jade Arnold

Many patients do not believe we in dentistry need to know about certain medications that “do not involve their teeth”. How do you get through to these patient and get by this notion?

Ann Eshenaur Spolarich RDH, PhD, FSCDH, Professor and Assistant Dean for Research, Arizona School of Dentistry & Oral Health, A.T. Still University

A great question! I always remind patients that their mouths are connected to their body, and that we take the responsibility of ensuring their safety and well-being as priority over any other needs or concerns. I then mention that many of the medications that we administer as part of dental treatment can interact with commonly prescribed medications which is one of the reasons why we ask about medication history. Also, we want to be sure that the patient is medically stable enough to undergo dental treatment. Give this a try - good luck!

L. L.

Pre-medication. What are the most updated guidelines

Ann Eshenaur Spolarich RDH, PhD, FSCDH, Professor and Assistant Dean for Research, Arizona School of Dentistry & Oral Health, A.T. Still University

The American Heart Association issued a Scientific Statement in May of 2021 with an update to the infective endocarditis guidelines. You can find it here: https://www.ahajournals.org/doi/epub/10.1161/CIR.0000000000000969 No changes in the orthopedic guidelines.

S. Z.

Would you add OTC vitamins and nutrition supplements as included in "polypharmacy".

Ann Eshenaur Spolarich RDH, PhD, FSCDH, Professor and Assistant Dean for Research, Arizona School of Dentistry & Oral Health, A.T. Still University

Absolutely!

Dr. Venkata Nalla

please update on current premeditation and sedation medications

Ann Eshenaur Spolarich RDH, PhD, FSCDH, Professor and Assistant Dean for Research, Arizona School of Dentistry & Oral Health, A.T. Still University

In 2021, the American Heart Association issued a Scientific Statement with an update on the infective endocarditis guidelines. You can find it here: https://www.ahajournals.org/doi/epub/10.1161/CIR.0000000000000969 I do not have updates on sedation guidelines

S. Z.

Is there additional risk for "trans" individuals?

Ann Eshenaur Spolarich RDH, PhD, FSCDH, Professor and Assistant Dean for Research, Arizona School of Dentistry & Oral Health, A.T. Still University

Not to my knowledge. Risk assessment would be the same: what is the health status of the patient, is the patient taking any medications, risks for drug interactions, risks for adverse drug events, etc. We need more research in this population.