Dental Medications

There are several types of medications that are used to manage a variety of diseases involving the oral cavity (mouth) that are part of good dental care. The medications discussed in this article have pharmacological properties that are used to treat conditions such as pain, anxiety, and infections, amongst others.

It is important to always communicate all dental signs and symptoms to your dentist, so that appropriate management and choice of medications can be made.

One of the most commonly reported dental complications involves various levels of pain. Due to this fact,pain managementis an important goal for all dentists and patients.

Non-narcoticanalgesics are the most commonly used drugs for relief of toothache or pain following dental treatment as well as fever. The commonly-used medications used are:

• ibuprofen(Nuprin艾德维尔布洛芬),acetaminophen(Tylenol), andaspirin(for example, Bayer);
  
  
• corticosteroids such as Orabase-HCA, Oracort, and Oralone are anti-inflammatory medications that are used to relieve discomfort and redness of the mouth;
  
  
• and for severe pain conditions, narcotic analgesics such as codeine or hydrocodone (Vicodin) may be given. Codeine formulations usually include acetaminophen for increased efficacy, for example, Vicoprofen and Tylenol #3.

Note:Ibuprofen occasionally causesxerostomia(dry mouth) that may increase oral plaque and dentalcaries(cavities).

Topical anesthetics come in ointments, sprays, or liquids. Topical anesthetics are used to prevent pain on the surface level of the lining of the mouth. They also can be used to reduce pain fromsuperficialsores in the mouth or to numb an area before an injectable localanestheticis given.

• Commonly usedtopical anestheticsinclude Anbesol and Orajel.
• Local anestheticsare injected into the deeper tissues of the mouth and work by inhibiting the impulses from pain-sensing nerves and hence are used to reduce pain especially in procedures involving drilling, and cutting of the tissue. Common local anesthetics are 2%lidocainehydrochloride and 2% mepivacaine (Carbocaine).
• General anestheticsare inhaled and include anti-anxiety agents, such as nitrous oxide, that help to ensure relaxation during dental visits and often may be used along with local anesthetics.

Note:Anesthetics are used for temporary pain relief, and should not be used for long durations of time.

Dental infections include infections that develop after dental surgery, for example:

• periodontal infections,
• dental abscesses,
• infections around wisdom teeth, and
• other conditions.

Antibiotics such aspenicillinandamoxicillin(Amoxil) are used for a variety of infections that may result after dental procedures.Erythromycin(Benzamycin,Emgel, Ery,Ilotycin,Staticin) is usually prescribed when patients have allergies to penicillin or amoxicillin (Amoxil).

• Clindamycin(Cleocin HCL) often is used in the treatment of serious infections caused by susceptibleanaerobicbacteria and hence is effective for dental abscesses in bone and soft tissue that doesn't respond adequately to penicillin or erythromycin.
• Chlorhexidine (marketed asPeridex,PerioChip, andPerioGardamongst others) is anantibioticused to control plaque andgingivitisin the mouth, or in periodontal pockets (the space between your gum and tooth). Chlorhexidine comes as a chip, which is used as an adjunct toscalingand root planing procedures for reducing the depth of pockets around the teeth in patients with adultperiodontitisor as a rinse, which providesantimicrobialactivity between dental visits.
• Tetracyclines, such asdoxycycline(marketed asAtridox) are used to help treatperiodontal disease.
• Another use of antibiotics in dentistry is for preventing bacteria that are always present on the surface of tissues around teeth from spreading into the blood. This is especially important in patients with some types of defective or artificial heart valves since blood-born bacteria have a tendency to settle on the valves and cause serious infections. The antibiotics may be given orally, intramuscularly, or even intravenously. They usually are begun immediately before the dental surgery and are continued for no more than a few doses, for example, less than a day or so.

Note:Chlorhexidine may cause staining of the tooth, tooth filling, and dentures, or other mouth appliances.Tetracyclineuse during tooth development phases (from the last half of pregnancy through eight years of age) may cause permanent discoloration (yellow, gray, brown) of teeth.

Antifungals are used for the treatment ofcandidiasisin the oral cavity. Certainantifungal medicationsuch asnystatin(Mycostatin) is used to treatCandida albicansinfection in the mouth, includingthrush, and denture stomatitis.

• Nystatin (Mycostatin) comes in lozenges/troches and oral suspension.
• When taking the oral suspension, patients are instructed to take one half of the dose on each side of the mouth, retaining the suspension as long as possible by swishing it around, before swallowing.

Fluorides

Fluoridewhich is available in most over-the-counter toothpaste is used to prevent tooth decay. Prescription-strength fluoride (Acidul) is also available if prescribed by a physician.

Antiseptics

Antiseptics are available as over-the-counter mouth rinses that are used to reduce plaque and gingivitis and kill germs that cause bad breath.

Benzodiazepines

Benzodiazepinessuch asdiazepam(Valium)用于the management of anxiety disorders or for the short-term relief of the symptoms of anxiety. It works by relaxing the patient during dental procedures such as temporomandibular joint disorders.

Saliva substitutes

Salivasubstitutes such as Moi-Stir, Mouth Kote, Optimoist, Saliva Substitute, Salix, andXero-Lube are used for treating dry mouth, an occasionalcomplicationofautoimmunediseases or occasionally unassociated with other diseases. They usually come as sprays and are used as needed.