Aubrey: How do you assume dentists can enhance their prescribing practices to foster higher affected person outcomes?
Barbara: Good communication and cautious analysis are necessary. Dentists ought to really feel snug reaching out to pharmacists after they’re not sure a few prescription, and they need to take the time to look into the medicines their sufferers are taking.
Persevering with training and drugs databases are nice methods to reinforce prescribing practices. In my expertise, I’ve seen that many dentists don’t keep updated with present medicines; as an illustration, some nonetheless prescribe Dolobid, an older anti-inflammatory, regardless of the supply of newer and simpler options. Utilizing the instruments they’ve out there might enhance affected person outcomes.Â
Aubrey: Are you able to give an instance of a typical problem than can come up from this lack of knowledge?
Barbara: Definitely. A standard scenario includes nonsteroidal anti-inflammatory medication (NSAIDs), corresponding to ibuprofen, which are sometimes prescribed for ache following dental procedures. With dentists more and more choosing NSAIDs as an alternative of opioids, it’s necessary for them to pay attention to all of the NSAIDs out there, together with OTC ones, to keep away from by chance prescribing a couple of.
Generally, sufferers get their medicines from totally different pharmacies, and one pharmacy won’t know a affected person is already taking one other NSAID, which might result in a critical GI bleed. Doing an intensive treatment verify may help forestall these sorts of points.
Aubrey: Are there particular medicines that may result in problems when prescribing for dental circumstances?
Barbara: Sure, antibiotics are a typical offender. Dentists steadily prescribe antibiotics for infections, however they generally overlook potential interactions. For example, combining metformin and cephalexin (Keflex) might improve the danger of lactic acidosis.
One other necessary factor to contemplate is that sure antibiotics can cut back the effectiveness of hormonal contraception. Azithromycin, erythromycin, penicillin, amoxicillin, ampicillin, tetracycline, and metronidazole all might lower the efficacy of oral contraceptives. Antifungals corresponding to nystatin and ketoconazole may additionally do that. Lack of diligence by the dentist and pharmacist might lead to authorized motion. One case I heard about led to the dentist and pharmacist to paying little one assist.
Aubrey: What can each professionals do to reinforce this interdisciplinary collaboration?
Barbara: Good communication is vital to retaining sufferers secure. Common staff conferences and shared digital well being information (EHRs) can actually assist bridge data gaps. In my expertise, pharmacists are all the time keen to debate prescriptions to make sure security, although this may generally frustrate docs, significantly when it disrupts their workflow.
Nevertheless, these questions are about clarifying potential points, not criticizing. For instance, I had a affected person who was prescribed amoxicillin regardless of having a penicillin allergy. After I checked with the dentist, he was unaware of the allergy as a result of the affected person hadn’t talked about it. This highlights the significance of open communication and understanding that everybody concerned is working towards the perfect final result for the affected person.
Aubrey: How do sufferers react when an incorrect prescription is named in?
Barbara: This presents a difficult scenario. Enjoying telephone tag with the physician can take time, and sufferers typically change into anxious or pissed off and marvel what’s taking place. Sufferers have instantly requested me, “Did my dentist make a mistake?” I attempt to shield the dentist with explanations corresponding to “I simply need to double-check the dose,” or “I am checking for interactions.” I consider many pharmacists do the identical. Sadly, this may end up in sufferers directing their frustration at us once we’re merely making an attempt to do our job and guarantee their security.
My dialogue with Barbara highlights how essential it’s for dentists to work carefully with pharmacists. Guaranteeing affected person security requires extra than simply good intentions—it calls for thorough treatment critiques and open communication. Instruments just like the Digital Drug Handbook supply sensible assist on this course of, serving to cut back the dangers related to prescribing, and in the end enhancing affected person outcomes.
