THE UNIVERSITY OF WESTERN AUSTRALIA1
DENT 3005: Introduction to Pharmacology
Medical and medication history
Dr Thuy Linh Truong thuy.truong@uwa.edu.au
Acknowledgement of country2
The University of Western Australia acknowledges that its campus is situated on Noongar land, and that Noongar people remain the spiritual and cultural custodians of their land, and continue to practise their values, languages, beliefs and knowledge.
Artist: Dr Richard Barry Walley OAM
Learning Outcomes3
Learning objectives
- Explain the rationale for each medical history question
- Identify how systemic diseases and medications impact dental treatment
- Practice applying this knowledge in clinical setting
Medical History4
- Professional duty
- Required by Code of Conduct
- Foundation for safe, ethical care
- Accurate records
- Factual, up-to-date, legible
- No biased or judgmental language
- Include history, diagnosis, treatment, and consent
- Continuity of care
- Clear for other providers
- Include social, cultural, and psychological factors
- Confidentiality
- Secure storage and access
- Follow privacy laws
- Patient rights: patients can access and request their records
Impressions 🙂5
- First impressions matter
- Build trust from the start
- Negative impressions can last
- Patient anxiety is common
- Be calm, friendly, and reassuring
- Team roles
- Dentist: hold the ultimate responsibility
- Receptionist, dental assistance: aid in building rapport
- Next steps
- What info is needed?
- How to collect it well?
Open Vs Closed Questions6
- Closed questions
- Require brief, definite answers (Yes/No)
- Useful for medical history
- E.g., Do you take medication?
- Open questions
- Begin with What, When, Who, Where, Which, or How
- Encourage detailed responses and feelings
- E.g., What are your main dental concerns?
- Use both types
- Helps gather complete and relevant info
- Sets the tone for a positive patient relationship
Personal history – why it matters7
- Confirm name, DOB, address, and contact details
- Job roles may affect oral health
- Eg. Pastry chef, sommelier…
- Stressful jobs → clenching, bruxism
- Occupation may influence treatment planning
- Eg. Singers or wind musicians
- Personal history provides context for tailored care
Medical history – a clinical essential8
- Critical for safe and effective treatment
- Prevents avoidable medical complications
- Use clear formats: verbal, written, or electronic
- Ensure patient understands the questions
- Signature ≠ comprehension
- Verify unclear answers
- Update regularly – health changes over time
Dental history – more than what you see9
- Ask about past and recent dental experiences
- Regular attendance?
- Recent treatments?
- Current pain or sensitivity?
- Bleeding gums?
- Dental anxieties?
- Patients often recall useful details not visible on exam
- Supports better diagnosis and treatment planning
- Helps build rapport and address patient concerns
Medical History Questions by System/Category10
| System/Category | Medical History Questions |
|---|---|
| Cardiovascular | Do you have any cardiovascular disease? (e.g. hypertension, heart disease) |
| Bleeding/Clotting disorders | Do you have a bleeding or clotting disorder? |
| Have you ever had excessive bleeding? | |
| Do you have any blood disorders (e.g. anaemia)? | |
| Respiratory | Do you have a respiratory disease? (e.g. asthma, emphysema) |
| Neurological | Do you have a neurological disorder? (e.g. epilepsy) |
| Gastrointestinal | Do you have a gastrointestinal disease? (e.g. coeliac disease, inflammatory bowel disease, gastritis) |
| Endocrine | Do you have an endocrine condition? (e.g. diabetes, thyroid disorder, dyslipidaemia) |
| Renal/Hepatic | Do you have kidney or liver disease? (e.g. hepatitis) |
| Bone-modifying agents | Have you ever taken medications such as bisphosphonates or denosumab? |
| Skin conditions | Do you have any skin diseases? |
| Psychological health | Do you have any psychological conditions? (e.g. anxiety, depression, dental phobia) |
| Cancer/Radiation | Do you have a history of cancer? |
| Have you received radiation therapy to the head or neck? | |
| Infectious disease | Have you ever had an infectious disease? (e.g. tuberculosis, hepatitis, HIV) |
| Hospitalisations | Have you had any past operations or hospitalisations? |
| Were there any complications? | |
| Pregnancy | Are you currently pregnant? If yes, what is your due date? |
| Allergies | Do you have any allergies to medications, food, or chemicals? |
| Medications | Are you currently taking any medications, including supplements? |
| Recreational drug use | Have you ever used recreational drugs? |
| Smoking/Vaping | Do you currently or previously smoke or vape? |
| Please specify product, quantity (per day/week), and duration | |
| Alcohol use | Do you consume alcohol? |
| Please specify type of drink, amount (per day/week/month/year), and duration |
PATIENT PERSONAL & MEDICAL QUESTIONNAIRE11
PRIVATE & CONFIDENTIAL
Welcome to our Practice Please answer these questions as completely as possible. It will greatly assist us to provide the best dental treatment for you.
Personal Information
Name(Mr/Mrs/Miss/Ms/Dr/Other) … (First Names) … (Family Name) …
Address … Postcode …
Date of Birth … Phone (Home) … Phone (Work) …
Phone (Mobile) … Preferred Daytime Contact: Home / Work / Mobile (Please Circle) …
E-mail …
Occupation … Employer …
Emergency Contact … Relationship … Phone …
Person responsible for payment of accounts …
Private Health Fund (if applicable) …
Whom may we thank for recommending you to our practice? …
Privacy Statement12
We value your privacy. All of the information which you provide to us will be held and used by us in accordance with our Privacy Policy. A copy of our Privacy Policy is attached to this Questionnaire. Please take the time to read through our Privacy Policy before answering the Questionnaire and speak to one of our staff members if you have any concerns about how we will use your personal information.
Medical History13
The state of your health may have a very significant effect on your dental care. Please answer these questions fully or discuss them with your dentist:
| Y | N | |
|---|---|---|
| I have private and confidential medical matters which I wish to discuss with the dentist | ☐ | ☐ |
| Are you receiving any medical treatment at present? | ☐ | ☐ |
| Have you ever been in hospital? | ☐ | ☐ |
Name of your medical practitioner/specialist …
If yes to hospitalisation, nature of hospitalisation and dates: …
Medications
Some medicines may interfere with your dental treatment or react with medicaments used by your dentist. It is important that your dentist knows precisely what medications (if any) that you are taking.
Please list any medications you are currently taking, or have been taking recently including injections, herbal remedies, vitamins, supplements, cold/flu treatments, sleeping pills, pain relievers, implants, so we can take appropriate precautions and avoid drug interactions.
| Drug Name | Dosage | Duration of Treatment | Purpose/Condition |
|---|---|---|---|
Allergies
Please list any known ALLERGIES or ADVERSE REACTIONS to drugs (especially antibiotics eg. penicillin), medicines, antiseptics, local anaesthetics, latex, preservatives that we should know about.
| Drug Name | Nature of Reaction | How Long Ago |
|---|---|---|
If you are in any doubt about your medication, please bring a Pharmacy Medication Summary or the bottle or packet(s) to the practice to show the dentist.
Medical Conditions14
Please indicate YES or NO if you have ever had any of the following:
| Condition | Y | N | Condition | Y | N |
|---|---|---|---|---|---|
| Rheumatic fever | ☐ | ☐ | Jaw, neck or shoulder injury or pain | ☐ | ☐ |
| Heart condition/cardiac surgery/pacemaker | ☐ | ☐ | Epilepsy/Seizures | ☐ | ☐ |
| Heart valve replacement | ☐ | ☐ | Thyroid disease (including goitre) | ☐ | ☐ |
| High or low blood pressure | ☐ | ☐ | Tuberculosis (TB) | ☐ | ☐ |
| Blood disorders | ☐ | ☐ | Asthma/Bronchitis/lung conditions | ☐ | ☐ |
| Excessive bruising or bleeding | ☐ | ☐ | Nervous system disorder | ☐ | ☐ |
| Hepatitis, jaundice or liver disease | ☐ | ☐ | Anxiety/Depression | ☐ | ☐ |
| Kidney/renal disease | ☐ | ☐ | Gastroesophageal reflux disease (GORD) | ☐ | ☐ |
| Diabetes | ☐ | ☐ | Cancer or malignancy of any kind | ☐ | ☐ |
| Osteoporosis or low bone density | ☐ | ☐ | Chemotherapy/Radiation therapy | ☐ | ☐ |
| Rheumatoid arthritis/Lupus (SLE)/Polymyalgia | ☐ | ☐ | Transplanted organ/bone marrow/stem cells | ☐ | ☐ |
| Joint replacement surgery | ☐ | ☐ | Snoring/Sleep Apnoea | ☐ | ☐ |
Lifestyle
- Have you ever smoked? Y ☐ N ☐ Approx date if quit …
- Do you currently smoke or vape? Y ☐ N ☐
- If yes, for how long? … How much do you smoke … per day
- Have you ever used illicit substances and/or recreational drugs? Y ☐ N ☐
- If yes, when? Recent ☐ More than 1 yr ago ☐
- Do you consume alcohol? Y ☐ N ☐
- Do you suffer from any illness not listed above or carry any infectious disease? Y ☐ N ☐
- If yes, please provide details …
For Female Patients15
- Are you pregnant or is there a chance you could be pregnant? Y ☐ N ☐
- If yes, date due …
- Are you currently breastfeeding? Y ☐ N ☐
Declaration
In signing this form I acknowledge that this represents an accurate medical history. I will advise my dentist of any changes to my medical history in the future. I understand that all medical details will be treated with complete professional confidentiality. I have read the privacy document provided by this practice.
Patient Signature: … Date …//… &s; &- (Parent or guardian under 18 years)
Dentist Signature: … Date …//…
Practice Use Only: Review of Information
Patient Signature: … Date …//…
Dentist Comment: … Signature … Date …//…
Patient Signature: … Date …//…
Dentist Comment: … Signature … Date …//…
Patient Signature: … Date …//…
Dentist Comment: … Signature … Date …//…
Cardiovascular conditions16
Case
A patient with hypertension on aspirin and a history of atrial fibrillation
Discussion points
- Why do we need to know about cardiovascular disease?
- How might aspirin affect dental treatment?
- What precautions are necessary before scaling or extractions?
Bleeding disorders17
Case
A 45-year-old female with von Willebrand disease scheduled for dental scaling
Discussion points
- How does a bleeding disorder affect dental treatment?
- What considerations are necessary?
- What considerations if patient has anaemia or unexplained bleeding?
Respiratory conditions18
Case
A 30-year-old asthmatic uses salbutamol regularly and has mild wheezing today
Discussion points
- How should treatment be modified?
- What emergency preparedness is required?
- How should asthma be managed in the dental setting?
- Are there any materials or procedures to avoid?
Neurological conditions19
Case
A 28-year-old with well-controlled epilepsy had a seizure 6 months ago
Discussion points
- What are the risks during dental care?
- How can seizures be prevented or managed?
Gastrointestinal conditions20
Case
A patient with Crohn’s disease presents with recurrent ulcers and clinically signs of enamel wear on upper palatal
Discussion points
- What oral signs are associated with Crohn’s?
- Any product sensitivities?
- Oral manifestations of some GI conditions
Endocrine conditions21
Case
A 55-year-old with type 2 diabetes on metformin and insulin
Discussion points
- How does diabetes affect periodontal health and healing?
- What are hypoglycaemia risks?
- What are the dental implications of diabetes?
- What timing is best for appointments?
Renal/Hepatic conditions22
Case
A patient with stage 3 chronic kidney disease
Discussion points
- What implications for drug prescribing?
- Dental implications for his medical conditions?
Bone modifying agents23
Case
A patient on denosumab for osteoporosis presents for an extraction
Discussion points
- What is MRONJ and how can it be prevented?
- Should extractions be delayed or avoided?
Skin conditions24
Case
A patient with severe eczema and known contact dermatitis
Discussion points
- What dental materials may trigger reactions?
Psychological health25
Case
A 25-year-old with severe dental anxiety and panic attacks
Discussion points
- How do mental health conditions affect dental care?
- How can we improve patient comfort?
Cancer/Radiation Therapy26
Case
A patient with a history of head and neck cancer and jaw radiotherapy
Discussion points
- What risks persist long after radiation?
- What is osteoradionecrosis?
- Considerations when treating this patient?
Infectious disease27
Case
A patient discloses HIV-positive status with an undetectable viral load
Discussion points
- Are there additional infection control measures?
- Is dental treatment safe?
- Oral manifestations?
Past operations/Hospitalization/Complications28
Case
Patient reports allergic reaction after general anaesthesia during childhood surgery
Discussion points
- How should you investigate this history?
- Does this affect dental care?
Pregnancy29
Case
A 32-year-old woman in her second trimester needing scaling and a filling
Discussion points
- Is it safe to treat during pregnancy?
- What precautions should be taken?
Allergies30
Case
Patient reports penicillin allergy as a child
Discussion points
- How should allergy be confirmed?
- What are safer alternatives?
Medication history (including complementary)31
Case
Patient is on SSRIs, fish oil, and St John’s Wort
Discussion points
- Why ask about supplements?
- Any drug interactions?
Recreational drug use32
Case
Patient occasionally uses cocaine and MDMA on weekends
Discussion points
- What are risks during dental procedures?
- How does drug use affect oral health?
Smoking/vaping33
Case
Long-term smoker, switched to vaping 6 months ago
Discussion points
- What’s the dental impact of smoking and vaping?
- Should cessation be discussed?
Alcohol use34
Case
Drinks 4 beers per night; recent liver test abnormalities
Discussion points
- What are oral and systemic impacts of alcohol?
- How does it affect treatment?
tions should be taken?
Allergies30
| Allergies | Do you have any allergies to medications, food, or chemicals? |
|---|---|
Case: patient reports penicillin allergy as a child
Discussion points
- How should allergy be confirmed?
- What are safer alternatives?
Medication history (including complementary)31
| Medications | Are you currently taking any medications, including supplements? |
|---|---|
Case: patient is on SSRIs, fish oil, and St John’s Wort
Discussion points
- Why ask about supplements?
- Any drug interactions?
Recreational drug use32
| Recreational drug use | Have you ever used recreational drugs? |
|---|---|
Case: patient occasionally uses cocaine and MDMA on weekends
Discussion points
- What are risks during dental procedures?
- How does drug use affect oral health?
Smoking/vaping33
| Smoking/Vaping | Do you currently or previously smoke or vape? Please specify product, quantity (per day/week), and duration |
|---|---|
Case: long-term smoker, switched to vaping 6 months ago
Discussion points
- What’s the dental impact of smoking and vaping?
- Should cessation be discussed?
Alcohol use34
| Alcohol use | Do you consume alcohol? Please specify type of drink, amount (per day/week/month/year), and duration |
|---|---|
Case: drinks 4 beers per night; recent liver test abnormalities
Discussion points
- What are oral and systemic impacts of alcohol?
- How does it affect treatment?
Footnotes
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