WORLD CONGRESS ON DENTAL AND ORAL HEALTH
Importance of Pharmacology in Dentistry
By : H H Patel
Dentistry is the branch of medical science dealing with the investigation, treatment, and prophylaxis of the ailments of teeth and oral cavity. Dental problems have increased in frequency as one of the effects of the modern lifestyle. This may be traced to several reasons including the higher intake of junk food, soft drinks and neglecting to take care of one’s teeth. Hence, dental visits have become the norm nowadays.
Dental science has evolved a lot over the last few decades just as other areas of medical science. Dental surgery have been modernized as well as digitalized. However, for a majority of dental ailments, dentists still rely on medications, either alone or as part of preoperative management. In order to treat dental problems with medications, an adequate knowledge of the underlying pharmacology is a must.
Pharmacology is an applied science dealing with drug action on the body, and the metabolism of drugs by the body.
Pharmacokinetics and Pharmacodynamics of Dental Drugs
Pharmacology plays an important role in dentistry. The aim of dental pharmacology is to understand the scientific aspects of how drugs used in dentistry act within various body systems.
Pharmacology encompasses two aspects of drug metabolism – pharmacokinetics and pharmacodynamics. While pharmacokinetics deals with drug absorption, distribution, metabolism, and excretion, pharmacodynamics deals with drug efficacy, safety, receptor occupancy (potency), and drug interactions. Knowledge of all these aspects with respect to a given drug is necessary in order to successfully treat a dental condition using the drug.
Pharmacokinetics
Following the oral or topical administration of a drug, its absorption requires that it be lipid soluble, as it can then diffuse through the epithelium and reach the capillaries.
Drug molecules travel in the bloodstream either in the free or unbound state, or bound to plasma proteins. Only the unbound drug is free and is distributed to the tissues. Further, the parent drug may be converted to a number of metabolites.
Either the parent drugs or their metabolites may be active/inactive and toxic/non-toxic. After metabolism, the course of elimination of the drug also varies depending on the route of administration and the physicochemical properties of the drug.
Pharmacodynamics
Drug action depends on the state of the receptors (active or inactive). Drugs interact with receptors in a variety of ways. Antagonists bind to receptors and do not activate either receptor state. Agonists bind as well as activate the receptors. Inverse agonists selectively stimulate the inactive receptor state by initiating the cellular response opposite to that generated by a natural agonist.
The efficacy and potency of drugs used in dentistry is determined by how well the drug binds with the receptors and triggers the desired response. The potency of these drugs is determined as the amount of drug required to produce a chosen intensity of effect. The drug doses are calculated for a given formulation (spray, gargle, rinse, tablet, ointment, or patch etc.) on the basis of all these factors. Additionally, it is equally important to understand the toxic effects associated with dental medicines, and any interactions with other drugs.
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