The medical history is an important tool in diagnosis and planning dental treatment. Most State Boards of Dentistry have specific statutes regulating the intervals at which these histories have to be done. Histories must be reviewed at every appointment and all medications reported by the patient, as they may affect treatment.
The Mouth/Body Connection
- Many patients have little understanding of what their medical history has to do with dental treatment. However, your teeth are attached to your body and are part of:
- Your circulatory system (in direct connection with your heart)
- Your central nervous system (if not, your dentist wouldn’t need to use anesthetic)
- Your musculoskeletal system (all of your teeth are cushioned in a bony socket and attached by ligament tissue to your head)
- Your lymph system (infections of the mouth drain to the lymph system through nodes under your chin and in your neck)
- Your immune system (in the presence of an infection, your immune system goes to work to help fight the infection)
Importance of an accurate medical history
The following list is a few of the factors the dental professional needs to know about regarding your past, present, and foreseeable future medical experience:
- Birth control pills – If you are taking birth control and your dentist gives you antibiotics, that medication can render your birth control ineffective.
- If you are on a blood thinner and you need a tooth removed, a conversation with your MD is necessary, as you may experience excess bleeding following an extraction.
- In Connective tissue disorders such as Rheumatoid Arthritis, oral microbes have been found in the joint fluid of patients. 1
- Diabetes is the number-one medical condition contributing to the progression and severity of gum disease. We now know that there is a direct relationship between the control of blood sugar and gum disease (periodontal disease). Uncontrolled gum disease adversely affects the control of blood sugar in diabetes and vice versa.
- Coronary artery disease – Bacteria involved in gum disease have been found in the atherosclerotic plaques of coronary arteries.
- Adverse pregnancy events – Pregnant women with gum disease may be more likely to give birth to pre-term, low-birth-weight babies. Oral bacteria can cross the placenta and expose the fetus to infection. 2, 3
- Congenital heart defects, a history of damage to the surface of the heart (endocarditis) or a history of rheumatic heart disease – Oral bleeding causes millions of bacteria to enter the bloodstream that pose a threat of damaging your heart valves. These conditions may require an antibiotic prior to dental treatment to protect the heart from further damage. Your MD should instruct you on your need for antibiotic treatment prior to dental visits.
- Mouth drying medications – There are hundreds of commonly prescribed medications that lead to a condition known as dry mouth. A decrease in saliva production can lead to oral disease costing thousands of dollars to repair.
- Recent joint replacement – Some orthopedic surgeons require a pre-medication for two years following joint placement. Talk to your surgeon about the necessity of being pre-medicated for dental appointments following your joint replacement surgery.
- Medication prescribed to treat osteoporosis: If you need an extraction and you do not tell the dentist about this medication, you could have serious problems with healing.
Many patients fail to fully inform their dental caregiver of their medical history, unknowingly putting themselves at risk for greater medical complications. If you choose to omit important information regarding your medical history and sign the form anyway, you are solely responsible for the outcome.
- Ogrendik, M. (2009). Oral bacteria found in RA synovial fluid: Oral bacteria directly associated with RA development. Modern Rheumatology. [Epub ahead of print]
- Katz, J. et al. (2009). Localization of P. gingivalis in preterm delivery placenta. Journal of Dental Research, 88(6): 575-78.
- Leon, R. et al. (2007). Detection of Porphyromonas gingivalis in the amniotic fluid in pregnant women with diagnosis of threatened premature labor. Journal of Periodontology, 78(7):1249-55.