Relationship building between dentists and pharmacists

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relationship building between dentists and pharmacists
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Building a deeper relationship with your local community pharmacist can help dentists bridge the pharmacological and clinical therapeutic knowledge gap. However, to achieve the best management and patient outcomes, dentists need to do some of the heavy lifting too. By Shane Conroy

Nobody should ever assume dentists have it easy. Between a busy clinical day and the many other business and financial challenges that come with owning a practice, dentists seldom have time to spare. This has given rise to many dentists feeling overwhelmed by the depth of drug knowledge required to optimise their sound prescribing protocols. 

Dr Andrei Tutoveanu knows this challenge all too well. He is the founder and principal dentist at Mosman Dentistry—and a dual registered dentist and pharmacist. He is also an active presenter and lecturer, regularly sharing his expert pharmacological and clinical therapeutic knowledge with dentists. He says the majority of dentists who attend his presentations identify a concerning lack of pharmacological and prescribing knowledge within the dental profession.

“Dentistry is a very difficult degree, and the universities are doing their very best to prepare young dentists to embark on a safe and clinically sound journey into the real world,” Dr Tutoveanu explains. “There are a plethora of core topics surrounding various protocols and procedures for our multiple indications and diagnoses to both understand and become proficient in. This makes it difficult to find more time for an in-depth appreciation of pharmacology and prescribing fundamentals, let alone to excel in this field.”

This leaves many experienced dentists and new graduates alike feeling overwhelmed by the multiple pharmacological-related challenges they face on a daily basis. These include assessing medical histories, medicinal indications, dose strengths and frequencies, and potential drug interactions. Dentists must also couple patients’ comorbidities and various drug allergies with other intrinsic pharmacokinetic and pharmacodynamic considerations. 

How your pharmacist can help 

Dr Tutoveanu says local community pharmacists are often willing and eager to assist dentists.

“However, there’s a limit to what a pharmacist can advise and recommend within our large spectrum of dental procedures and protocols, especially given our highly specific niche. This is where we, as a profession, need to embark on some heavy lifting too,” he explains.

There are a plethora of core topics surrounding various protocols and procedures for our multiple indications and diagnoses to both understand and become proficient in.

Dr Andrei Tutoveanu, founder, Mosman Dentistry

“I definitely recommend that dentists build a good working relationship with their local pharmacists who can provide general advice and guidance. Pharmacists are also at the forefront of the pharmaceutical industry, and able to update us about new drugs or recently added generics. Cultivating this relationship can also help dentists improve their knowledge and legal requirements surrounding prescription-writing. Also, there have been multiple medications over the last six months—particularly antibiotics commonly prescribed in dentistry—that have been out of stock for weeks,” Dr Tutoveanu adds. “A pharmacist can keep you informed with advice on alternative drugs you can consider during these periods.”

Dr Tutoveanu emphasises: “This collaboration can, and should, be undertaken in a collegial and encouraging manner, without discouragement or disparity from either profession. Ideally, we should always aim for an environment in which both the dental and pharmacy professions work together to achieve our patient’s best outcome, which is the primary goal in any health profession collaboration.”

What you need to know

However, there is a limit to what a pharmacist can advise and recommend within dentistry’s large and complex spectrum of procedures and protocols. There’s really no substitute for dentists expanding their own pharmacological and clinical therapeutic knowledge. Dr Tutoveanu says he uses his pharmacological and therapeutic expertise to improve treatment outcomes on a daily basis.  

“Often patients will be taking medications for existing comorbidities at various dosage regimens,” he explains. “Knowing how certain drugs are metabolised and excreted assists my prescription protocols and prevents potentially serious health complications for my patients. 

“For example, if the patient already takes medications that are either highly metabolised by their liver or highly cleared by their kidney, your additional prescribed medications could overwork those organs, resulting in a potential hepatic crisis or acute renal failure, respectively.”

It’s better to bridge each other’s knowledge and experience together in a symbiotic relationship because, at the end of the day, our shared goal is to provide the best clinical management and patient outcome we can.

Dr Andrei Tutoveanu, founder, Mosman Dentistry

In surgical interventions, pharmacological knowledge can prove crucial for improving healing with optimal prescription protocols that consider contributing factors and predictable inflammatory cascades. This results in better clinical management and patient outcomes, especially during the post-op phases. 

“For instance, when treating a patient with healing issues, are the causes due to genetic factors, comorbidities, or medication-induced reactions? In those cases, a simple extraction could result in a difficult healing outcome—or even a lack of healing—simply because there wasn’t an appreciation or a comprehensive appraisal of the pre-existing comorbidities and/or current medication profile.

Dr Tutoveanu also notes that pharmacists may also find value in seeking advice from dentists. 

“Apart from many dentists contacting me directly for prescribing and therapeutic advice regarding their own patient cases, pharmacists also seek my advice regarding dental presentations and differential diagnosis of patients walking into their pharmacy. This ultimately results in correctly triaging and referring that patient—based on their signs and symptoms—to a dentist instead of our medical colleagues.

“Having an appreciation of each other’s strengths allows us to be more collegial and not competitive in nature,” Dr Tutoveanu concludes. “It’s better to bridge each other’s knowledge and experience together in a symbiotic relationship because, at the end of the day, our shared goal is to provide the best clinical management and patient outcome we can.”   

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