Aubrey: How do you assume dentists can enhance their prescribing practices to foster higher affected person outcomes?
Barbara: Good communication and cautious analysis are essential. Dentists ought to really feel comfy reaching out to pharmacists after they’re uncertain a couple of prescription, and they need to take the time to look into the drugs their sufferers are taking.
Persevering with training and medicine databases are nice methods to boost prescribing practices. In my expertise, I’ve observed that many dentists don’t keep updated with present drugs; for example, some nonetheless prescribe Dolobid, an older anti-inflammatory, regardless of the provision of newer and simpler alternate options. Utilizing the instruments they’ve obtainable might enhance affected person outcomes.
Aubrey: Are you able to give an instance of a standard difficulty than can come up from this ignorance?
Barbara: Actually. A typical scenario entails nonsteroidal anti-inflammatory medication (NSAIDs), akin to ibuprofen, which are sometimes prescribed for ache following dental procedures. With dentists more and more choosing NSAIDs as a substitute of opioids, it’s essential for them to concentrate on all of the NSAIDs obtainable, together with OTC ones, to keep away from by accident prescribing a couple of.
Typically, sufferers get their drugs from totally different pharmacies, and one pharmacy won’t know a affected person is already taking one other NSAID, which might result in a severe GI bleed. Doing a radical treatment verify will help forestall these sorts of points.
Aubrey: Are there particular drugs that may result in issues when prescribing for dental circumstances?
Barbara: Sure, antibiotics are a standard wrongdoer. Dentists steadily prescribe antibiotics for infections, however they often overlook potential interactions. For example, combining metformin and cephalexin (Keflex) could enhance the danger of lactic acidosis.
One other essential factor to contemplate is that sure antibiotics can scale back the effectiveness of hormonal contraception. Azithromycin, erythromycin, penicillin, amoxicillin, ampicillin, tetracycline, and metronidazole all could lower the efficacy of oral contraceptives. Antifungals akin to nystatin and ketoconazole might also do that. Lack of diligence by the dentist and pharmacist could lead to authorized motion. One case I heard about led to the dentist and pharmacist to paying baby help.
Aubrey: What can each professionals do to boost this interdisciplinary collaboration?
Barbara: Good communication is essential to holding sufferers secure. Common workforce conferences and shared digital well being information (EHRs) can actually assist bridge info 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.
Nonetheless, 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 most effective consequence for the affected person.
Aubrey: How do sufferers react when an incorrect prescription is known as in?
Barbara: This presents a difficult scenario. Taking part in cellphone tag with the physician can take time, and sufferers usually turn into anxious or pissed off and surprise what’s occurring. Sufferers have instantly requested me, “Did my dentist make a mistake?” I attempt to shield the dentist with explanations akin to “I simply wish 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 after we’re merely attempting to do our job and guarantee their security.
My dialogue with Barbara highlights how essential it’s for dentists to work intently with pharmacists. Guaranteeing affected person security requires extra than simply good intentions—it calls for thorough treatment evaluations and open communication. Instruments just like the Digital Drug Handbook supply sensible help on this course of, serving to scale back the dangers related to prescribing, and finally bettering affected person outcomes.
