IN the effort to mitigate the hassle of modern life and in the quest for respite, ironically, uncontrolled self-medication in all forms is practised, which sometimes leads to serious situations. In addition, unfortunately, dental personnel prescribe medications for their patients unnecessarily, an act which constitutes drug abuse. While all drugs produce undesirable side effects, cognisance must also be given to the various conditions derived from the use of certain drugs.
Up to 8 grams (one third of an ounce) of sugar is added to every 2 teaspoons of liquid medication to preserve the product and mask an unpleasant taste. If taken at least three times a day, the last intake is often at bedtime and perhaps kept in the mouth for a minute or two before being swallowed. The effect on the teeth will be catastrophic, rapidly leading to dental decay.
Aspirin is probably the most frequently used drug. Indeed, it is widely believed to be capable of preventing chronic heart disease if taken consistently and is promoted as the best medicine for arthritis. However, a daily intake of 2 to 3 aspirins results in 5 millilitres (one teaspoon) of blood being lost in the faeces every 24 hours due to the erosion effect on the protective mucosal barrier of the stomach.
If this continues for some time without dietary iron supplementation, the person may eventually develop iron deficiency anaemia, the symptoms of which can include a smooth tongue surface, tenderness in the oral cavity, pain on swallowing, tiredness, and shortness of breath. Hookworm infestation may present identical symptoms. Because oral symptoms predominate, the dentist is likely to be the first to diagnose the problem, especially in postmenopausal women.
Every patient currently on systemic corticosteroid medication should receive an extra dose of the medication on the day he/she visits the dentist. If this is not done, the stressful experience could trigger an adrenal insufficiency syndrome with a sudden fall in blood pressure, leading to severe shock and even death.
It is estimated that the risk of an allergic reaction in asthmatic patients is 5 to 10 times higher than in normal patients. They are especially prone to allergic reactions when treated with penicillin or aspirin. Aplastic anaemia is a serious and sometimes fatal complication of drugs that depress the bone marrow, leading to a halt in the production of red and white blood cells and platelets. One of the first symptoms in this condition is spontaneous bleeding of the gums with oral sores in a very pale patient.
Among the drugs known to induce bone marrow depression are chloramphenicol and phenylbutazone, commonly used to treat typhoid and arthritis respectively. Patients suffering from grand mal epilepsy (the type with convulsions) usually take hydantoin sodium. This drug causes the gums to swell, which may ultimately cover most of the tooth crowns.
It is advisable that before dental treatment, these persons should have pre-medication with sedatives such as diazepam or oxazepam. Chlorhexidine is a widely used, highly effective mouth disinfectant. The recommended concentration for routine use is 0.2%. It is well known that Chlorhexidine can cause discolouration of the teeth and tongue while inducing taste disturbances.
Consequently, as an important participant in the treatment process, the dangers of potential drugs must never be underestimated.
