COMMENTARY

The Importance of the Medication History in Oral Healthcare

Eric T. Stoopler, DMD

Disclosures

September 03, 2015

Outpatient Medication Use and Implications for Dental Care: Guidance for Contemporary Dental Practice

Fitzgerald J,Epstein JB, Donaldson M, Schwartz G, Jones C, Fung K
J Can Dent Assoc. 2015;81:f10

Medications Taken by Dental Patients

Increased numbers of patients with complex medical problems are seeking dental treatment.[1] This can be attributed in part to the demographic shift in the United States: By the year 2050, it is estimated that 56% of the US population will be at least 55 years of age and 25% of the population will be at least 65 years of age.[2] The most rapidly growing segment of the population is over the age of 85.[2]

According to one report, 39% of persons over the age of 65 have chronic conditions that limit daily activities.[3] The most prevalent conditions noted in this report were heart disease, hypertension, diabetes, chronic bronchitis, and arthritis.[3] Pharmacologic management of systemic disease has grown significantly, with nearly 60% of the US population taking at least one prescription medication.[1,2] Fitzgerald and colleagues sought to characterize the current state of medication use in outpatient dental practice.

A total of 352 consecutive patients referred to a periodontal practice in a 2-month period were enrolled in the study; however, data from only 322 patients were included for analysis because 30 patients refused to provide written consent. The primary source of study data was patient self-reported medication use and medication allergies documented in their health history forms on admission to the practice, which were confirmed through personal interview. The data was de-identified for research purposes and analyzed using Microsoft Excel.

The results of the study were:

  • Participants included 164 females and 158 males with a median age of 52 years (range, 6-94);

  • 64% of patients were taking prescription or over-the-counter (OTC) medications or both;

  • The average number of total medications (prescription and nonprescription combined) taken per patient was approximately three;

  • The average number of prescription medications taken per patient was approximately two;

  • The five most common prescription medication classes were antihypertensives (35%), blood thinners (12%), psychiatric medications (10%), hypoglycemic medications (9%), and gastric ulcer medications (8%);

  • The most common OTC medication classes were dietary supplements (22%) and vitamins (12%); and

  • The most commonly reported medication allergy was to antibiotics (19%), with penicillin-allergy ranked highest (11%) followed by sulfa medications (5%).

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