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Epilepsy, Seizure Meds Have Oral Health Implications

Epilepsy, Seizure Meds Have Oral Health Implications

Three million Americans suffer from epilepsy, a central nervous system disorder resulting in recurrent seizures, which can be frightening and potentially dangerous. Additionally, seizures may have implications for oral health and dental care, according to an article in the July/August 2003 issue of General Dentistry, the clinical, peer-reviewed journal of the Academy of General Dentistry (AGD). If you suffer from seizures, it is crucial that you keep your dentist informed, according to author Eric T. Stoopler, DMD.

“It’s extremely important for patients to give their dentist a thorough history of their seizures and lists of medications and dosages. Dentists also should be updated on patients’ progress with their neurologists and other health care professionals,” says Dr. Stoopler.

Seizures can be treated with medication or, in some instances, surgery; but antiseizure drugs often have side effects that can cause oral health problems or complicate dental procedures. Additionally, drugs commonly used in dentistry could induce seizure activity in epileptics.

Dr. Stoopler urges seizure sufferers to make sure their dentist is aware of their specific conditions. And most important, you should make sure that your dentist knows how to handle a seizure should you have one during a dental treatment, says Dr. Stoopler.

“Armed with the full knowledge of a patient’s condition, a dentist can take all the necessary steps to ensure a safe and comfortable visit,” according to AGD spokesperson Mark Ritz, DDS, MAGD.

Drs. Ritz and Stoopler also urge epileptics to visit their dentist frequently, as side effects such as dry mouth and overgrown gums require careful attention to oral hygiene.

Side effects of seizure medications:

  • Increased incidence of infection
  • Xerostomia (dry mouth)
  • Gingival hypertrophy (overgrown gums)
  • Delayed healing
  • Bleeding gums
  • Postoperative bleeding

Dental visit tips for epileptics:

  • Take medication prior to your appointment.
  • Inform your dentist of your complete medical history, including seizure history, medications and dosages and contact information      for other health care providers.
  • Schedule appointments within a few hours of taking medication.
  • Tell the dental team immediately if you experience an aura.
  • Avoid drinking alcohol before your appointment.

Original content of this reprinted with permission of the Academy of General Dentistry. © Copyright 2007-2009 by the Academy of General Dentistry. All rights reserved. Read the original article here.

How Do Herbal Medications Differ From Conventional Drugs?

How Do Herbal Medications Differ From Conventional Drugs?

Although many of the prescription and over-the-counter drugs used today are derived from plants, there is a big difference between the two. Conventional drugs, which must be approved for use by the Food and Drug Administration (FDA), are based on an active ingredient. Manufacturers find a chemical that provides a desired response when taken into the body, and then they synthesize that chemical. In other words, a conventional drug is based on a chemical that is made in a laboratory, even though it may have originally come from a plant.

Herbal or botanical medications are taken from the natural chemicals within a plant. Either the extract is taken in its original form, sometimes combined with other herbal extracts, or it is refined. When an herbal medication is refined, the essential extract is taken out of the plant source, concentrated and then added back to make the original herbal medication more potent.

Why do I need to tell my dentist if I take herbal supplements?

Always tell your dentist about all medications and supplements you are taking and how much you take. From vitamins to Echinacea, everything you put in your body causes a certain reaction, and some alternative medicines are very potent. That reaction can interfere with medications your dentist gives you or enhance them to cause a much stronger reaction. If your dentist doesn’t know what drugs or supplements you have taken, he or she will not know how to protect you from possible substance interactions.

What are some combinations I should avoid taking?

Even the most common herbal and vitamin supplements can have serious side effects for some patients. Blood thinners, such as the popular ginkgo biloba, and even vitamin E can be dangerous when taken with aspirin, which also acts as a blood thinner. Because this may cause a situation in which some patients’ blood will have difficulty clotting, serious surgical procedures should be avoided after taking such a combination of supplements.

Vitamins can be dangerous as well, if you aren’t careful. Vitamin C, when taken in the thousands of grams, can cause problems and weaken the efficiency of anesthesia. On the other hand, if you are taking a calming supplement, such as kava kava or St. John’s wort, this can enhance the effects of the anesthesia your dentist gives you and cause problems.

What will my dentist do when I tell him or her about the supplements I take?

It is important that your dentist has all the information, including your medical history, herbal medication and conventional drugs you are taking. If your dentist knows that you are taking a medication that can interact with something he or she is planning on giving you, there are a variety of solutions from which to choose. Your dentist may have you stop taking the herbal medication until the treatment is over or choose a different drug for treatment, if one is available. There are so many new alternative medications on the market today that a dentist may not know about all of them and their side effects. If your dentist is not familiar with the medication, he or she will make it his or her job to find out if a treatment is safe for your situation.

Many patients who take alternative medicines may not tell their dentist. They are afraid the dentist will not respect their decision to take an herbal medication and might tell them to stop taking it. The truth is, as herbal medications become more popular, many dentists are beginning to use them in their practices. Your dentist might even have an alternative, herbal solution for you.

Where can I go for information on alternative therapies?

The best person to ask is a physician who is licensed in naturopathic medicine. There are a few accredited schools in the United States that offer degrees in natural healing. Some of these schools can offer referrals to their graduates. For example, you can go to the American Association of Naturopathic Physicians Web site to look up a variety of licensed practitioners in your area

Original content of this reprinted with permission of the Academy of General Dentistry. © Copyright 2007-2009 by the Academy of General Dentistry. All rights reserved. Read the original article here.

Oral Reactions to Medication Can Include Black Tongue

Oral Reactions to Medication Can Include Black Tongue

Dentists are often the first to diagnose and treat oral reactions, especially since many reactions occur with any medications used in excess, or in combinations with other drugs, such as vitamins and herbs, according to a report in the March/April 2005 issue of General Dentistry, the Academy of General Dentistry’s (AGD) clinical, peer-reviewed journal.

The mouth can react differently to drugs and those reactions can vary in significance, according to Scott S. DeRossi, DMD, lead author of the recent study.

“An adverse reaction depends on the drugs you use. Too much bismuth subsalicylate, which is used to treat diarrhea and upset stomach, for example, can turn your tongue black, but the reaction is temporary and harmless,” says AGD spokesperson Eric Shapira, DDS, MAGD, MA. “Also, too much antibiotic usage can do the same thing and give you a black, hairy-looking tongue. Any acidic type of medication can cause canker sores, including chewable vitamin C.”

Other types of reactions are possible, as well. Some reactions can be prevented, but the dentist must be aware of what drugs, vitamins and herbs the patient is taking.

“Most of these reactions, however, cannot be prevented, but early recognition, appropriate treatments and changing drug regimens can eliminate them,” explains Dr. DeRossi.

He notes that, as the population ages and more drugs become available, patients can expect to encounter additional oral side effects from medications.

“A dentist can help, both in diagnosing drug interactions and in writing prescriptions that would be good to take in order to avoid side effects. Some side effects are not dangerous and others are, depending on the extent of drug administered and the kind of drug that is used. Don’t forget that vitamins in excess become drugs and can cause serious damage and injury,” says Dr. Shapira.

How to avoid and treat an oral reaction to medication:

  • Let your dentist know what drugs, vitamins and herbs you regularly take.
  • Visit your dentist when you suspect that a reaction is occurring due to medication you are taking.
  • Use vitamins, herbs and over-the-counter medications only as directed by your physician.

Original content of this reprinted with permission of the Academy of General Dentistry. © Copyright 2007-2009 by the Academy of General Dentistry. All rights reserved. Read the original article here.

Taking Herbal Supplements? Tell Your Dentist

Taking Herbal Supplements? Tell Your Dentist

Alternative medicine isn’t so alternative anymore. Once dismissed as a fad or fringe movement, alternative medicine has become an increasingly popular component of mainstream health care, including dentistry.

But patients need to use caution when using any alternative, “natural” treatments, including herbal supplements.

“‘Stop, look and listen’ applies to the health-food counter as much as the intersection,” says Academy of General Dentistry spokesperson Eric Z. Shapira, DDS, MAGD. Most patients neglect to include vitamins and herbal remedies when listing their medications for their dentist or physician. But even the most common herbs, such as St. John’s wort and ginkgo biloba, can cause serious health problems if taken in combination with other drugs or taken in extreme dosages.

“People think herbs are harmless because they are considered ‘natural,’ and they think, if one is good, 10 are better,” said Dr. Shapira. But overdoing it with supposedly safe herbs can cause health problems as serious as internal bleeding and heart arrhythmia, Dr. Shapira warns.

He also points out that all drugs are natural. “Almost all medicines start out as plants, but established drugs have the benefit of being standardized and regulated by the Food and Drug Administration,” he says. Herbal medications are not standardized or regulated in any way.

Dr. Shapira urges patients to be well informed before taking any herbal concoction or embarking on an alternative therapy such as acupuncture, chiropractic or even aromatherapy. That means more than reading the manufacturers’ promotional material or Internet sites.

Canker sore? Try a teabag

Dr. Shapira recommends some natural remedies for oral health:

Fluoride – This naturally occurring mineral has been proven to protect teeth from decay. Many municipal water supplies contain fluoride. Other sources are fluoride toothpaste, mouthwash and topical rinses and pastes applied in the dental office.

Alcohol-free mouthwash – Some common mouthwashes contain alcohol to cover up the smell of plaque. But alcohol dries out the mouth, which can cause discomfort and create an environment for more plaque to thrive.

Tea – A folk remedy that works, wet tea bags can provide relief from canker sores, swollen gums and toothache.

Zinc – This mineral is widely available in lozenges that can relieve the pain of a sore throat. But Dr. Shapira urges patients to use zinc sparingly. As with any herb, vitamin or mineral, patients need to follow directions and inform their dentist of its use.

Original content of this reprinted with permission of the Academy of General Dentistry. © Copyright 2007-2009 by the Academy of General Dentistry. All rights reserved. Read the original article here.

Treatment Drug May Cause Jawbone to Die

Treatment Drug May Cause Jawbone to Die

Breast cancer patients, individuals at risk for osteoporosis, and individuals undergoing certain types of bone cancer therapies often take drugs that contain bisphosphonates. Bisphosphonates may place patients at risk for developing osteonecrosis of the jaws (a rotting of the jaw bones), according to a case report and literature review that appeared in the May/June 2006 issue of General Dentistry, the Academy of General Dentistry’s (AGD) clinical, peer-reviewed journal.

Bisphosphonates are a family of drugs used to prevent and treat osteoporosis, multiple myeloma, Paget’s disease (bone cancers), and bone metastasis from other cancers. These drugs can bond to bone surfaces and prevent osteoclasts (cells that breakdown bone) from doing their job.

“Healthy bones constantly rebuild themselves,” explains co-author of the report Sally-Jo Placa, DMD, MPA. “However, since the jawbones have rapid cell turnover, they can fail to heal properly in patients taking any of the bisphosphonate drugs. Patients need to be aware of the possibility of complications from dental surgery or extractions.” Since these drugs linger in the bone indefinitely, they may upset the cell balance in how the jaws regenerate and remove unhealthy bone.

In their report, the authors refer to the case of a woman who received bisphosphonate therapy intravenously to treat metastatic breast cancer. She then developed osteonecrosis in her upper and lower jaws following tooth removal.

“This type of osteonecrosis has been occurring since the advent of these drugs,” explains co-author Wellington S. Tsai, DMD. “At this time osteonecrosis as a result of bisphosphonate therapy has no treatment.”

Patients who are taking bisphosphonates should inform their dentist to prevent complications from dental surgical procedures. “By informing your dentist that you are taking a bisphosphonate, different avenues for treatment can be explored,” says the report’s third co-author Kayvon Haghighi, DDS, MD.

“It is strongly recommended that patients scheduled to receive bisphosphonate therapy should visit a dentist or an oral surgeon so problematic teeth can be treated prior to the start of therapy,” the authors state.

“Widespread use of bisphosphonates to prevent or treat early osteoporosis in relatively young women and the likelihood of long-term use is a cause for concern,” says Dr. Placa. “How bisphosphonates interfere with healing after dental surgery is still unclear and further research will be needed. It is imperative that the public understands there is no present treatment or cure for this problem.”

Tips to reduce the risk for osteonecrosis of the jaw and maintain a healthy mouth:

  • Inform your general dentist or specialist if you are taking bisphosphonates.
  • Check and adjust removable dentures.
  • Obtain routine dental cleanings.
  • Opt for root canal therapy over extractions when possible.

Original content of this reprinted with permission of the Academy of General Dentistry. © Copyright 2007-2009 by the Academy of General Dentistry. All rights reserved. Read the original article here.

Why Does My Dentist Prescribe Medication?

Why Does My Dentist Prescribe Medication?

Your dentist prescribes medications for many reasons. While some drugs are formulated to fight oral diseases, others are used to prevent infections after surgical procedures such as tooth extractions and gum surgery. Certain drugs are used prior to dental treatment. These medications are used to help fight infections and also to control existing conditions such as heart murmurs and valve problems. Your dentist will discuss with you what medications you will be taking, when you will take them and why.

What should I find out about my medication?

Ask your dentist what you should look for after you’ve begun treatment. Ask about common side effects and what you should do if you experience them. Also ask about anything you should not take with the new drug, since the drug may interact with other prescription and over-the-counter medications and with certain foods. Ask your pharmacist any additional questions you did not ask the dentist. If you get a medication that looks different from the one you have been taking, speak up immediately.

When your dentist writes a new prescription, keep a record noting the brand name, generic name, the purpose, the dosage, how many times per day the drug should be taken and for how long. Every prescription dispensed by a pharmacist comes with a patient information sheet describing everything you need to know about the drug. Read the sheet before beginning your prescription, and read it each time before you take the drug. If you take several medications, keep a diary to check your daily intake and note any symptoms.

How do I know if I am experiencing a side effect or an allergic reaction to medication?

Some patients are allergic to certain drugs and can experience side effects that range from mild irritations, such as rashes, to more serious problems, such as breathing difficulties. Fortunately, fewer than 5 percent of allergic reactions are life-threatening. An allergic reaction is the result of an overreaction in your body’s immune system, which fights what it perceives to be a foreign substance.

Not all side effects are allergy-related and can occur regardless of your body’s disposition toward them. By and large, these side effects are rare and are expected by the drug’s manufacturer. Depending on the drug, some side affects may include nausea, drowsiness or headaches. Your dentist may be able to lower the dosage or change the drug’s formula to reduce or eliminate these side effects. It is important to discuss side effects with your dentist or pharmacist to determine if you are suffering from an allergic reaction or not. Don’t discontinue a medication without talking with your dentist first. This could prolong the healing process.

What should my dentist know about my medical history?

It is important to share with your dentist your medical history and the medications you are taking, especially for serious conditions such as kidney, lung, heart or liver disease. Some dental medications have the potential to interact with other drugs and cause you harm or treatment failure.

Don’t assume your dentist knows your medical history. The most common cause of drug -related interactions is the doctor’s lack of information about your medical history. Update and review your history every time you see the dentist. In addition to informing your dentist of past prescriptions, tell him or her about any adverse reactions. Include any vitamins, supplements or herbal remedies you take on the list, as well as any diet plans.

What else should I know about my prescription?

When taking any medication prescribed by your dentist it is important to finish it. Many people take prescribed medicine, especially antibiotics, only until they feel better. Dosages are exact and are necessary to fight or prevent infections. By taking medication only until you feel better, all the drug has done is eliminate susceptible microorganisms and left the ones that tend to become drug-resistant. Ask your dentist before you take any non-prescription medications, vitamins, herbal remedies or dietary supplements. If you don’t feel well after taking a medication, consult your dentist or pharmacist.

Original content of this reprinted with permission of the Academy of General Dentistry. © Copyright 2007-2009 by the Academy of General Dentistry. All rights reserved. Read the original article here.