We have all been frustrated with a Monday morning new patient emergency who was seen over the weekend at a hospital’s emergency department or at an urgent care center. They generally have two prescription bottles, one for an antibiotic better suited for a bladder infection and the other for a whole lot of opioid analgesics. They were told to take them and, “You need to see a dentist!”
We wish that we might have been consulted about what is most appropriate in that situation.
The problem with patients seeking dental care at emergency departments or urgent care centers is nationwide, and solving it is far beyond the scope of this blog. However, it might be possible for us to at least share a little medication advice with our physician colleagues when they have to deal with patients who present with dental emergencies.
How best to share that advice was the topic of discussion at a Sheboygan County Oral Health Partnership meeting last year. Representatives from the local hospitals thought this would be helpful.
Using some information that had previously been shared in Brown County hospitals as a template, Dr. Laura Rammer (Sheboygan) and I refined the basic information and updated the medication recommendations, especially regarding the use of opioids.
When I shared this information at the most recent Wisconsin Dental Association Board of Trustees meeting, I learned there were others who had similarly tried to reinvent the wheel. In hopes of trying to create an even better template which we could be shared with all WDA members for outreach to local hospitals and urgent care centers, I am asking our readers to share what they are using in their area so we can establish some best practices advice for our physician colleagues statewide.
Please email your local medication/pain reliever guidance to Dental Practice and Government Relations Associate Erika Valadez at [email protected].
Watch future WDA member communications for an update on this simple, yet important, project.
I notice an increase prescribing of Clindamycin, is there any concern of GI issues, should a probiotic be part of the regime?
Clindamycin is an excellent choice for moderate to severe dental infections where the prescriber wants ensure coverage of gram(-) anaerobes not covered by drugs like Penicillin, Amoxicillin, Cephalexin or Azithromycin.
All prescribers should be concerned with antibiotic induced colitis.
This can occur with any of the antibiotics used to treat dental infections, not just Clindamycin.
For this reason, prescribers should recommend all patients take a probiotic with the prescribed antibiotic.
Critical to this is NOT taking the drugs together. Probiotics contain live bacteria, if the antibiotic and the probiotic are taken together, the therapeutic value of the probiotic is lost.
Probiotics should be taken 2 hours after an antibiotic and usually are taken twice a day.