“It’s All About The Medical History!”: Essential Pharmacology for Busy Dental Professionals

Anesthesia, Basic Science, Pain Management, Pharmacology

Mysteries Behind the Medical Histories!
What potential complications lurk behind the patient’s medical history that may impact dental therapy, alter treatment plans and perhaps even result in medical emergencies? Armed only with a summary of past and current disease states and a list of current medications, will you be able to decipher the clues, solve the mystery and employ innovative treatment strategies to save the day?

This program will provide an overview of the dental implications of the medications, supplements and substances of abuse most frequently used by patients. This course will provide practical tools dental professionals can apply every day to assist them in interpreting the information contained in a patient’s medical history and understanding the impact on dental treatment planning and patient care.

1. The Medical History
   1. Importance of the Medical History
   2. Essential Components of the Medical History
   3. Strategies for the Successful Patient Interviews
2. Patient One
   1. Review of Medical History As Presented
   2. Review of Systemic Diseases
   3. Discussion of Oro-Systemic Connections
   4. Review of Medications and Treatments
   5. Review of Dental Considerations
   6. Discussion of Treatment Planning Strategies
3. Patient Two
   1. Review of Medical History As Presented
   2. Review of Systemic Diseases
   3. Discussion of Oro-Systemic Connections
   4. Review of Medications and Treatments
   5. Review of Dental Considerations
   6. Discussion of Treatment Planning Strategies
4. Patient Three
   1. Review of Medical History As Presented
   2. Review of Systemic Diseases
   3. Discussion of Oro-Systemic Connections
   4. Review of Medications and Treatments
   5. Review of Dental Considerations
   6. Discussion of Treatment Planning Strategies

Appropriate Prescribing Practices for Opioid Analgesics in the Dental Office
Management of acute dental pain is accomplished with the use of non-opioid and opioid analgesics. However, this normally occurs outside the dental office, away from the immediate supervision of the clinician, who is often faced with the difficult task of managing patient pain while also avoiding adverse outcomes for both the patient and their communities. Thus, it is critical for clinicians to be able to accurately identify the need for pain control, individualize patient care based on this need as well as associated risks, assess the efficacy of analgesic agents prescribed and monitor for their appropriate use. This program will provide participants with an overview of the pharmacology of pain control and the effective management of acute dental pain using non-opioid and opioid analgesics. Special emphasis will be given to appropriate prescribing practices for opioid analgesics.

5. The Concept of Pain
   1. Pain Threshold and Pain Tolerance
   2. Psychosocial and Emotional Factors
   3. Pathophysiology of Pain
6. Identification of Opioid Addiction
   1. Techniques and Cues For Identifying Opioid Abuse
   2. Strategies For Managing Opioid-Abusing Patients
7. Management of Acute Dental Pain –
   Non-opioid Analgesics & Acetaminophen (APAP)
   1. Clinical Pharmacology
   2. Equianalgesic Doses
   3. NSAIDs
      1. Mechanism of Action
      2. Pharmacologic Effects
      3. Clinical Considerations – Adverse Reactions, Drug Interactions & Contraindications
8. Management of Acute Dental Pain –
   Opioid Analgesics
   1. Clinical Pharmacology
   2. Available Formulations
   3. Codeine, Hydrocodone, Oxycodone
      1. Mechanism of Action
      2. Pharmacologic Effects
      3. Clinical Considerations – Adverse Reactions, Drug Interactions & Contraindications
9. Appropriate Opioid Prescribing Practices
10. Preventing Opioid Abuse and Diversion

Pharmacology and Therapeutics of Local Anesthesia: An Overview & Update
Due to their potential for producing life-threatening systemic adverse reactions, a thorough knowledge of the pharmacological and clinical properties of local anesthetic agents is essential for their safe and effective use. This program will provide participants with an overview of the pharmacology and therapeutics of local anesthetic agents. Special emphasis will be given to those agents commonly administered in dental practice and patient management techniques necessary with specific disease states.

11. Local Anesthesia Pharmacology Basics
    1. Neuroanatomy
    2. Neurophysiology
    3. Biochemistry and Mechanism of Action
12. Review of Dental Local Anesthetic Preparations
    1. Local Anesthetic Agents for Injection
    2. Local Anesthetic Agents for Topical Use
    3. Vasoconstrictors
13. Patient Care Considerations
    1. Medical History Review
    2. Physical Evaluation
    3. Significant Drug Interactions
    4. Absolute Contraindications
    5. Relative Contraindications
    6. Considerations with Epinephrine
14. Patient Management
    1. The Medically Complex Dental Patient
    2. Treatment Modifications
    3. Patient Care Planning