Excessive bleeding: ADA highlights importance of medical history taking in dentistry

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Excessive bleeding: ADA highlights importance of medical history taking in dentistry

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An understanding of patients’ medical history may give important insights into their health, help the delivery of the most appropriate care and help complications to be avoided during treatment. (Image: Valeri Potapova/Shutterstock)

SYDNEY, Australia: Taking a thorough medical history is vital as it helps to identify conditions that may affect dental treatment and consequently reduces the risk of a patient experiencing a medical emergency. Additionally, it helps to identify the oral manifestations of systemic disease. Given that certain medications and supplements that patients are taking might also increase the risk of bleeding during dental treatment, Australian Dental Association (ADA) President Dr Stephen Liew cautioned dental professionals not to underestimate the importance of recording patients’ medical history in order to improve treatment outcomes.

Earlier last week, the ADA elected Dr Liew to be its new president. Dr Liew has been a general dentist for 15 years and has had over ten years of experience serving on numerous boards. He has worked in both private and public sectors and has been the recipient of various awards and fellowships for his contributions to dentistry. On commencing his role, Dr Liew warned dental professionals about the dangers of not knowing a patient’s medical history.

According to the ADA, two-thirds of Australians regularly take complementary medicines. Evidence suggests that certain supplements and herbal remedies, including turmeric, ginger, garlic, ginkgo biloba, ginseng, glucosamine, evening primrose oil and fish oil, are risk factors for patient bleeding. Additionally, some prescription medications, such as antidepressants, non-steroidal anti-inflammatory drugs and blood thinners as well as certain combinations of drugs, may enhance bleeding.

“Dentists sometimes treat people without knowing the full range of prescription, complementary or over-the-counter medications patients are taking as many Australians aren’t aware of the importance of sharing this vital information with their clinician,” he commented. “This can be problematic when we perform a procedure where bleeding needs to be controlled, such as a tooth extraction,” he added.

“Many Australians aren’t aware of the importance of sharing this vital information with their clinician.”
— ADA President Dr Stephen Liew

Taking a full medical history during the patient’s first visit is a crucial step in patient evaluation. It includes information on family history, past operations and procedures, illnesses, and current and previous medications. It is the cornerstone of safe and effective treatment as well as personalised care.

“It’s about an open and trusting relationship between clinician and patient,” Dr Liew commented.
According to the ADA, its members receive regular training and updates regarding how various medicines act in the body and interact with one another and have access to a consultant pharmacist who can respond to individual situations.

“Sometimes that may mean advising the patient to come off a certain medication for a period—in consultation with their doctor—in the run up to a dental procedure which could result in bleeding.”

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