Dentistry

Dentistry

December 1, 2018

Dentistry

We work together with dentists and their patients to solve problems using customized medications.

Upon a prescription order, we can compound:

  • lip balms for viral lesions
  • topical muscle relaxants/analgesics
  • topical anesthetics
  • non-staining antibacterial rinses
  • oral sedation in lollipops and freezer pop
  • lollipops for oral thrush
  • mouth rinses for aphthous ulcers or chemotherapy-induced stomatitis
  • mouth rinse to stop oral bleeding during dental procedures for patients who take
  • anticoagulants
  • dry socket preparations
  • “mucosal bandages” to cover ulcerated, infected, or tender mucosa
  • lozenges that help to prevent gagging
  • and many more unique preparations and novel delivery systems

Medications are manufactured in a limited number of strengths and dosage forms that will satisfy the needs of most patients due to stability concerns, and the cost of stocking and distributing numerous formulations of each drug. Using pharmaceutical grade chemicals and specialized equipment not found in most pharmacies, we can compound medications in doses and dosage forms that are not commercially available. We want to optimize the care of every patient. Just let us know what you need!

Suppressing the Gag Reflex

The gag reflex can cause a patient considerable discomfort as well as interfere with dental procedures. An electrolyte tablet administered and retained intraorally a few minutes before the start of a procedure can suppress the gag reflex, allowing a mandibular block to be given with much greater ease, which further reduces the gagging reflex.

Tablets can be prescribed for home use for patients who can not properly perform oral hygiene procedures due to the gagging problem. Severe gaggers may need to repeat a dose in 15 to 20 minutes. (Dent Today. 1991 Dec;10(9):68-71). Some patients and dentists prefer to use electrolyte lollipops.

Miracle Mouthwashes

Compounding dental mouthwashes or rinses may offer numerous advantages over commercially available dosage forms. Elixirs, syrups, and suspensions often contain preservatives such as alcohol which can cause reactions or gastrointestinal irritation, or sugar which makes the preparation undesirable for prolonged use in the mouth or for diabetic patients. A customized preparation without unnecessary excipients – i.e., a sugar-free, dye-free, lactose-free, and preservative-free dosage form – can eliminate concerns of palatability, alcohol content, and dyes which may stain exposed mucosa.

Various preparations are also available to treat burning mouth syndrome and anesthetic/analgesic and antibiotic/anti-infective mouthwashes are commonly requested.

“Magic mouthwashes” are topical solutions or suspensions prepared to relieve symptoms of various oral pathologies. A study conducted at the Department of Clinical Pharmacy, University of California, San Francisco, described the usage of topical oral solutions in patients experiencing chemotherapy-induced oral mucositis (CIOM), and surveyed the care of oral mucositis provided to patients by clinical oncology pharmacists in institutional settings. The top five ingredients used to compound “magic mouthwash” were reported to be diphenhydramine, viscous lidocaine, magnesium hydroxide/aluminum hydroxide, nystatin and corticosteroids. Most institutions administer the mouthwash every 4 hours or every 6 hours.

J Oncol Pharm Pract. 2005 Dec;11(4):139-43.
Survey of topical oral solutions for the treatment of chemo-induced oral mucositis.
Chan A, Ignoffo RJ.

Periodontal Therapy

Compounding allows countless active ingredients to be incorporated into customized mouthwashes, gels, troches, etc. For example, to treat periodontal disease, antibiotics can be formulated as a mouthwash, or added to an oral adhesive paste or a plasticized gel that will maintain the contact between the tissue and medication for a prolonged period of time.

Therapy for Temporo-Mandibular Joint Disorder (TMJ)

Transdermal application of NSAIDs such as ketoprofen results in significantly higher tissue levels beneath the site of application than are achieved with oral administration. Additionally, side effects such as gastrointestinal irritation are avoided.

The following article concludes: “Topical non-steroidal anti-inflammatory drugs are effective in relieving pain in acute and chronic conditions.”

BMJ. 1998 Jan 31;316(7128):333-8

Quantitative systematic review of topically applied non-steroidal anti-inflammatory drugs.

A topical gel containing 18% potassium complex, 10% dimethyl isosorbide, and 72% aqueous hydroxy ethyl cellulose was gently rubbed onto the facial skin over the painful TMJ, muscles of mastication, and myofacial area. Complete pain relief occurred in 45 of 54 patients in this study within 5 minutes of the first application of the gel. Also, Complete pain relief happened in all 54 patients after the third day of applying the gel twice daily.

J Oral Implantol. 2007;33(6):365-70.
A new, noninvasive approach for successfully treating the pain and inflammation of TMJ disorders.

Leave a Reply

Your email address will not be published. Required fields are marked *