Here you will find a description of the most commonly used drugs in dental care. The dose of the drugs and instructions on how to take them will differ from patient to patient, depending on what the drug is being used for, patient's age, weight, and other considerations.
Even though your dentist will provide information to you about any medication he or she may give to you, make sure you fully understand the reasons for taking a medication and inform your dentist of any health conditions you may have.
Drugs to Control Pain and Anxiety
Local anesthesia, general anesthesia, nitrous oxide, or intravenous sedation is commonly used in dental procedures to help control pain and anxiety. Other pain relievers include prescription or nonprescription anti-inflammatory drugs, acetaminophen (Tylenol), and anesthetics.
Corticosteroids are anti-inflammatory drugs that are used to relieve the discomfort and redness of mouth and gum problems. Corticosteroids are available by prescription only and are available as pastes under such brand names as Kenalog in Orabase, Orabase-HCA, Oracort, and Oralone.
Your dentist may recommend a nonprescription anti-inflammatory drug -- such as Motrin -- to relieve mild pain and/or swelling caused by dental appliances, toothaches, and fevers. Tylenol may also be given.
Note: Unless directed by your dentist, never give infants and children aspirin.
Dental anesthetics are used in the mouth to relieve pain or irritation caused by many conditions, including toothache, teething, and sores in or around the mouth (such as cold sores, canker sores, and fever blisters). Also, some of these medicines are used to relieve pain or irritation caused by dentures or other dental appliances, including braces.
Anesthetics are available either by prescription or over-the-counter and come in many dosage forms including aerosol spray, dental paste, gel, lozenges, ointments, and solutions. Dental anesthetics are contained in such brand name products as Ambesol, Chloraseptic, Orajel, and Xylocaine.
Note: The FDA has issued a warning to consumers about the use of benzocaine, the main ingredient in over-the-counter liquids and gels used to reduce teething pain in very young children. Benzocaine is associated with a rare but serious condition called methemoglobinemia, which greatly reduces the amount of oxygen carried through the bloodstream. The FDA says benzocaine products should not be given to children younger than age 2 unless under the supervision of a health care professional.
Also, because the elderly are particularly sensitive to the effects of many local anesthetics, they should not use more than directed by the package label or the dentist. Anesthetics used for toothache pain should not be used for a prolonged period of time; they are prescribed for temporary pain relief until the toothache can be treated. Denture wearers using anesthetics to relieve pain from a new denture should see their dentist to determine if an adjustment to the appliance is needed to prevent more soreness.
Chlorhexidine is an antibiotic drug used to control plaque and gingivitis in the mouth or in periodontal pockets (the space between your gum and tooth). The medication is available as a mouth rinse and as a gelatin-filled chip that is placed in the deep gum pockets next to your teeth after root planing. The drug in the gelatin-filled chip is released slowly over about seven days. Dental products containing this antibacterial are marketed under various prescription-only brand names, such as Peridex, PerioChip, and PerioGard, as well as other over-the-counter trade names.
Note: Chlorhexidine may cause an increase in tartar on your teeth. It may also cause staining of the tooth, tooth filling, and dentures or other mouth appliances. Brushing with a tartar-control toothpaste and flossing your teeth daily may help reduce this tartar build-up and staining. In addition, you should visit your dentist at least every six months to have your teeth cleaned and your gums examined. Be sure to tell your dentist if you have ever had any unusual or allergic reaction to this medicine or to skin disinfectants containing chlorhexidine.
Your dentist may recommend the use of an over-the-counter antiseptic mouth rinse product to reduce plaque and gingivitis and kill the germs that cause bad breath.
Drugs Used to Treat Periodontal Disease
The doxycycline periodontal system (marketed as Atridox) contains the antibiotic doxycycline and is used to help treat periodontal disease. Doxycycline works by preventing the growth of bacteria. Doxycycline periodontal system is placed by your dentist into deep gum pockets next to your teeth and dissolves naturally over seven days.
Note: Tell your dentist if you have ever had any unusual or allergic reaction to doxycycline or to other tetracyclines. Use of doxycycline periodontal system is not recommended during the last half of pregnancy or in infants and children up to 8 years of age because the product may cause permanent discoloration of teeth and slow down bone growth. Use of doxycycline periodontal system is not recommended, if breastfeeding, since doxycycline passes into breast milk. This class of drugs also may decrease the effectiveness of estrogen-containing birth control pills, increasing the chance of unwanted pregnancy.
Fluoride is a drug used to prevent tooth decay. It is available on a nonprescription basis in many toothpastes. It is absorbed by teeth and helps strengthen teeth to resist acid and block the cavity-forming action of bacteria. As a varnish or a mouth rinse, fluoride helps reduce tooth sensitivity. Prescription-strength fluoride is available as a liquid, tablet, and chewable tablet to take by mouth. It usually is taken once daily. It is prescribed for children and adults whose homes have water that is not fluoridated (has not had fluoride added to water).
Note: Before taking fluoride, be sure to tell your dentist if you are allergic to fluoride, tartrazine (a yellow dye in some processed foods and drugs), or any other drugs. Do not take calcium, magnesium, or iron supplements while taking fluoride without checking with your dentist. Tell your dentist if you are on a low-sodium or sodium-free diet. Do not eat or drink dairy products one hour before or one hour after taking fluoride. Fluoride can cause staining of the teeth.
Pilocarpine, marketed as Salagan, may be prescribed by your dentist if you have been diagnosed with dry mouth. The drug stimulates saliva production.
- Tetracyclines (the class of drugs including demeclocycline, doxycycline, minocycline, oxytetracycline, and tetracycline) and the drug triclosan (marketed as Irgasan DP300) are also used in dentistry. These medications may be used either in combination with surgery and other therapies, or alone, to reduce or temporarily eliminate bacteria associated with periodontal disease, to suppress the destruction of the tooth's attachment to the bone or to reduce the pain and irritation of canker sores. Dental antibiotics come in a variety of forms including gels, thread-like fibers, microspheres (tiny round particles), and mouth rinses.
- Muscle Relaxants may be prescribed to reduce your stress to help you stop grinding your teeth and to treat temporomandibular joint disorders.
- Antifungals are prescribed to treat oral thrush. The goal of treatment is to stop the spread of the Candida fungus. Antifungal medicines are available in tablets, lozenges, or liquids that are usually "swished" around in your mouth before being swallowed.