Dental

Pharmacology

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 Dental Pharmacology
 Oral Hygiene
 Obtudents
 Mummifying agents
 Drugs used for cavity toilets &
periodontal disease

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 Oral hygiene
 Oral hygiene means care of oral mucous
membrane & teeth it includes
a) Sialagouge
b) Dentrifrices
c) Mouth washes
d) Bleaching agents

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 Sialagouge
 It increases the salivary secretion, it
includes
1. Bitter
2. Autonomic Cholinergic drugs
3. Autonomic Ganglion blocking drugs
4. Stimulant substances

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 Dentrifrices
 Therapeutic mechanical aids meant for
cleansing the teeth with the help of a
brush.
 Available as tooth powder or tooth
paste,
 Ideal tooth paste or powder contains the
following ingredients.
1. Abrasive agents
2. Detergents
3. Antiseptics
2 April4.2018Sweetening agents 5
 Abrasive agents
 Dentalabrasives are fine powder
preparations
 They are used,
1. to help the scouring action of tooth brush
mechanically and
2. for cleaning, polishing and filling the teeth
 Most commonly used dental abrasives are
pumice and precipitated calcium
carbonate.

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 Abrasives (contd….)
 Pumice consists of silicates of aluminum,
potassium and sodium.
 To polish, fill and clean teeth pumice with
glycerin is employed.

 Precipitated calcium carbonate is a mild

abrasive which is employed to give the
final polish to silver amalgam fillings. It is
also used to prepare tooth paste and tooth
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 Detergents
 These are cleaning agents.
 Sodium bicarbonate: it is mild alkali, acts by
dissolving proteins

 Hydrogen Peroxide: acts by liberating oxygen

 Hard Soaps:
 act by dissolving fatty substances mucous plaques and
lowering surface tension.
 causes loosening of debris adhering to teeth
 acts as lubricants when scrubbed over the teeth and gums
 proportion in most tooth paste varies from 5 – 25%.

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 Antiseptics
 Value is limited

 VolatileOils: Thymol, Menthol, Eugenol,

Cinnamon up to 1%

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 Sweetening Agents
 Saccharine commonly used

 Other agents: Sucrose and Lactose

 Sucrose causes less fermentation.

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 Coloring Agents
 Make preparations more attractive and
acceptable

 Red color: Azorubri, Liquor rubri, liquor

caramini or tincture coci.

 Blue color: Methylene Blue.

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 Dentrifrices-Ideal dentrifice
 An Ideal preparation should be
 Non-caustic to the mucous membrane

 Non-decalcifying and non-over abrasive to the teeth

 Non-poisonous to the body as a whole
 Not inhibit the secretion and alter the reaction of
saliva
 Not destroy the ferments of saliva
 Have pleasant taste, odor and consistency
 Have sufficient cleaning action.

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 MOUTH WASH
 These are mechanical agents used for
gargles.
 Types:
 Therapeutic: to reduce plaque, gingivitis,
dental caries and stomatitis.
 Cosmetic: are used to reduce bad breath

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THERAPEUTIC MOUTH WASH
HYDROCORTISONE,
NYSTATIN,
ANTIHISTAMINE AND Stomatits
TETRACYCLINE

Pilocarpine xerostoma

Tranexamic acid prevention of bleeding

after oral surgery
Amphotericin B oral candidiasis
Chlorhexidine gluconate plaque control

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 Types
1. Antiseptics: H2O2, KMnO4, Phenol and
KClO3, Thymol, Menthol and
Sodiumpercholate.
2. Astringent: ZnO2, Alcohol and ZnCl. These
make a protective layer over the mucosa of
oral cavity.
3. Demulcent: Glycerin, liquoron. They form a
protective layer and prevent attack of
bacteria.
2 April Antacid: Like Sodium bicarbonate
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 Moth wash (contd…)
 Generally they contain four groups of
excipients:
 Alcohols: used as solublizing agent for some
flavoring agents as well as preservatives.
 Surfactants: used to reduce debris by providing
foaming agents
 Flavors
 Coloring agents

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 Ideal Mouth wash
 Non-caustic to the mucous membrane
 Non-decalcifying and non-over abrasive to the
teeth
 Non-poisonous to the body as a whole
 Not inhibit the secretion and alter the reaction
of saliva
 Not destroy the ferments of saliva

 Have pleasant taste, odor and consistency

 Have sufficient cleaning action
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 BLEACHING AGENTS
 They remove the coloring pigments from the
teeth and these are,

1. Oxidizing Agents: like perhydrol, pyrozone, sodium

peroxide hyderogenperoxide.

2. Chlorinating Agents: like chlorinated Soda lime.

3. Reducing Agents: like Sodiumthiosulphate.

 Boric acid, Sodiumthiosulphate and chlorinated

soda lime are packed in the oral cavity in
powder form and to hasten the evolution of
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2018 drop of acetic acid is used. 18
 Special Stains
Bleaching agent
Stain
used
Weak ammonia or
Iodine stains Sodium thiosulphate
solution.
Hypochlorite or Iodine
Silver stains
solution
Iron stains Hypochlorite
Stains of many Chlorinated lime and
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days Acetic acid 19
 OBTUDENTS
 Agents used to diminish the dentine
sensitivity so that excavation may become
painless.
 Classification is according to mode of action.

1. By paralyzing sensory nerve endings: Phenols,

Camphor, Thymol, Clove oil & Alcohol.
2. By precipitating protein: Silver nitrate and Zinc
chloride.
3. By destruction of nerve tissue: Alcohol 70%.

 At present the use of obtundents has declined

due to the availability of local anesthetics (e.g.
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xylocaine)
 Properties of good Obtudents
 Should not produce any irritation or pain.

 Should not stain the denture.

 Should penetrate the dentine sufficiently to

remove the sensitivity.

 CLOVE OIL is an ideal obtudent

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 Draw backs
 Irritative agents may cause the formation
of secondary dentine If applied for long
periods.

 The pulp may shrink

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 MUMMIFYING AGENTS
 Used to harden & dry the tissue of pulp and
root canal so that tissue may maintain an
aseptic conditions resistant to infection,
especially in cases where it is impossible to
remove the pulp and contents of the root canal
completely.
 To accomplish the desired goal more than one
drug will be employed in the form of a paste.
 Mainly Astringents and antiseptics are used in
the form of paste.
 Paraform, Liquor formaldehyde, Cresol,
Amino-silver nitrate and Iodoform, Tannic
Acid can also be used.
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 Peridontal Diseases
 Peridontal disease can refer to any condition
that affects the gums and other structures
supporting the teeth.
 The most common forms of periodontal disease
are caused by bacterial infections.
 The mildest form of infection is gingivitis, which
affects only the gums.
 More severe disease damages the other
supporting structures of the tooth. This can lead
to tooth loss.

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2 April 2018 25
 Peridontal Diseases- Antibiotics
 Tetracycline antibiotics, which include
tetracycline hydrochloride, doxycycline, and
minocycline, are the primary agents used.
 They not only have anti-bacterial actions, but
also, they reduce inflammation and help block
collagenases, even in low doses.
 In fact, it is these two actions, rather than their
antibacterial properties, which seem to
contribute most to periodontal protection

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 Peridontal Diseases- Antibiotics
 Macrolide antibiotics (e.g., roxithromycin).

 Quinolone antibiotics (e.g., moxifloxacin,

ciprofloxacin) may specifically target A.
actinomycetemcomitans, an important bacteria
in periodontal disease.

 Metronidazole in combination with tetracycline

or amoxicillin. Such combinations may be used
for severe and chronic periodontal disease.

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 ROOT CANAL THERAPY
(RCT)
 It is the treatment of non vital tooth in
which pulp is damaged & exposed due to
trauma injury or caries. In this pulp is
removed & canal is sealed with suitable
drugs.

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 Pulp tissue dies due to caustic drugs or infection

Necrosis -> Gangrene -> Putrefaction

tissues liquefied and gas often evolves,

the gangrene spreads rapidly involving the whole pulp

If pulp cavity is not opened the increased pressure in pulp chamber may force
bacteria through the apical foramen where they will cause the
peridontitis or alveolar abbesses

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STEPS FOR CARRAYING RCT
 Removal of micro organism form the
cavity
 Use of obtudent
 Use of mummifying agents
 Use of filling material
 Prophylaxis

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 REMOVAL OF MICROORGANISM FROM PULP CAVITY

 For this patient must take antibiotic course

pirior to pulpectomy cavity. Drugs of
choice are penicillin, sulphonamide these
are used to prevent the growth of
microorganism, reduces pain & irritation &
stimulates perapical repair H2O2 is also
used it is an antiseptic but not potent one.

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 ANTISEPTIC USED TO STERILIZE ROOT
CANAL

 The ideal drug used for root canal therapy

should.
 Germicidal to all organism
 Rapidly effective
 Capable of deep penetration
 Effective in presence of organic matter
 Non injurious to peripecial tissues
 Non staining to the teeth

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 THE PHENOL GROUP

 Beech wood, cresol, tricresol, cresatine,

paramonochlorphenol,
paramonochlorophenol is dissolved in
portion of three part with 7 parts of
camphor.

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 POLYANTIBOTIC PASTES

POLYANTIBIOTIC PASTE
 Consist of penicillin bacteriacin chlorophenicol,
strephtomycin & sodium caprylate.
The antibiotic used are sulfonamide used are
baetercostatic, Penicillin alone or combination of
penciling & Streptomycin have limited effects on the
organism of root canal so the polyantibiotic pastes was
introduced in 1955 by Grossman this paste contain many
antibiotics. It consists of

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  10,0000 units of Penicillin G (Effective against gram +ve organism
 )

 10000 units of bacteriacim Effective against gram +ve organism

RESISTANCE TO PENCILLIN

 1 G of Streptomycin Effective against gram +ve organism

 1 G of Sodium Caprylate destroy fungi
 3 cc D. C fluid silican
 A similar paste supplied by the Boots drug
comp
 Penicillin G. 0.2 mega units
 Streptomycin 0.2 mega units
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 Chloromphenicol 0.2 g
 Sodium capryltate 0.2 g
 Silicon DC 200.6 millions

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 QUATERNARY AMMONIUM COMPOUND

 Compounds such as certimide non injurious to tissues

act in the presence of organism
 Monaern is active against gram –ve & gram +ve bacteria
but not against ps pyocyanus slight active aginst candida
 cetrimide belongs to quaternary ammonium compound,
detergent active ataisnt gram –ve the & gram +ve
organism as well as ps pyocyanus but it has only limited
effect on Candida.

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 HALOGEN DERIVATIVES

There are two salts of

(a)Chloramine

(b)Chloramide in a strength of 1 in 125.

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 Root Canal Filling Materials
 Root Canal filling material should be aseptic, non-irritant
and able to seal the apex of the root, the dentine
foramina and tubules
 They act as firm barrier against moisture, and bacteria.
 They are
 Permanent filling e.g Gold, silver, copper amalgam
 Semi permanent filling e.g cements composits
 Temporary filling e.g gutta-percha points, calium
hydroxide cements

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 Root Canal Filling Materials
 Root Canal filling material should be
aseptic, non-irritant and able to seal
the apex of the root, the dentine
foramina and tubules
 They act as firm barrier against
moisture, and bacteria.

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 Prophylaxis
 Stanous flouride 80% after every six
months to avoide formation of caries
 Fissure sealents applied on over the
occlusal surface to prevent food particals
ot an other narcotic material into
dangerous zone.

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 Drugs for local haemostasis
 Styptics: These are local haemostatic
agents.
 The preparation used is,
1. Human Fibrinogen
2. Human fibrin foam
3. Human Thrombin.
 Adrenaline 1:1000 parts, a
vasoconstrictor can be used locally.

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 DRUGS USED FOR CAVITY
TOILET
 Alcohol, H2S and Tricresol.
 H2S is an oxidizing agent and has
antiseptic properties.
 Not a very strong antiseptic as it liberates
O2 very quickly.
 But it inhibits the growth of anaerobic
bacteria.

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 Alcohol
 Distinct smell and burning taste.
 Ethyl Alcohol, 70% solution is used for
dental procedures.
 It penetrates rapidly but not deeply and is
not toxic to pulp.
 It acts by precipitating protein in the dental
tubule.
 Benzyl alcohol can also be used alone or
with Chloroform and Ethyl Alcohol , in ratio
5:3:2.
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