Vii diuretics ie furosemide hctz viii pain

vii. Diuretics
i.e. furosemide, HCTZ
viii. Pain medications (<1%)
i.e. Percocet, Norco
II. Smoking cessation
a. How it impacts oral health: Tobacco products ↑risk of severe gum disease, teeth discoloration, bone
deterioration, and oral cancer
i. Pharmacological TX options for smoking cessation:
1. Nicotine Replacement Therapy (NRT)
a. Transdermal patches
b. Gum
c. Lozenges
2. Chantix (varenicline)
3. Zyban (bupropion SR)
III. Anticoagulants and Antiplatelets
a. How it impacts oral health: ↑ risk of bleeding and prolongs healing time
i. For extensive surgery, root removal, or bone removal, consider reducing or holding
anticoagulation therapy
ii. If holding warfarin , time held should be based on severity of procedure, age of patient,
current INR, indication, and current dose of warfarin
iii. If holding an Factor Xa inhibitor , length of days held before procedure should be based on
CrCl of patient
iv. Aspirin (ASA) as a sole antiplatelet agent used for ischemic stroke prevention is safe to
continue during dental procedures
v. Premature discontinuation of patients on dual anti-platelet therapy may increase risk of stent
thrombosis leading to a myocardial infarction or death (i.e. ASA + clopidogrel, Effient
(prasugrel), or ticagrelor)
1. The American Heart Association in collaboration with the American Dental
Association along with other professional healthcare organizations stresses a 12-
month therapy of dual antiplatelet therapy after placement of a drug-eluting stent in
order to prevent thrombosis at the stent site. Any elective surgery should be
postponed for 1 year after stent implantation, and if surgery must be performed,