Medical Chair-side reference helps dentists to think like Physicians

Dentist's guide to medical conditions and complications is a newly launched book by Blackwell Publishing, aimed to assist dentists when treating medically compromised patients. The guide outlines protocols for treating patients with common conditions, presents essential drug interaction information, and guides the dental professional through the prevention and management of in-office medical emergencies. Dental Learning Hub spoke to Dr Kanchan Ganda, Director of Medicine at Tufts Dental School, USA, who compiled and edited the guide.

Question: Briefly explain the background of the guide; how the idea came about and how you became involved.

Kanchan Ganda: I started working in the dental setting by accident but have continued to stay in it full-time, by choice! The more I worked with dentists and dental students, the more I felt the need for creating a curriculum that would enhance and blend medical knowledge with pharmacology into dentistry so they could become proficient and less fearful in caring for the medically compromised dental patient.

Question: In your opinion, what are the most impressive features/aspects of this book?
Kanchan Ganda: This book has a balanced blend of medicine, pharmacology, common laboratory tests, assessments and evaluations, and deviations in guidelines for optimal patient care with most disease states encountered in the dental setting. It is an all-in-one text that can be an excellent chair-side reference, when urgently required.

Question: To whom (and in which contexts) would this guide be the most beneficial?
Kanchan Ganda: This text is a beneficial guide to a wide spectrum of users; from the dental student learning patient assessment and the application of the integration of medicine in dentistry towards patient care of the medically compromised dental patient, to the dental practitioner, practicing either general dentistry or speciality dentistry and treating medically compromised patients.

Question: Would you say this book contributes towards the general trend in dentistry of treating patients more holistically, as opposed to only the oral cavity?
Kanchan Ganda: This text is geared towards treating the patient as a ‘whole’ and not just indulging in the practice of, ‘drill, fill and bill’ dentistry. Practicing this type of dentistry qualifies the dentist as a ‘physician of the oral cavity’ as explained further.

The practitioner takes into account the patient’s general medical health status including fear of dentistry; requesting and assessment of common laboratory test results to determine the control levels of underlying disease states for implementation of appropriate modifications in patient care; the drug to drug interactions between the patient’s medications and the anaesthetics, analgesics and antibiotics (AAAs), used in dentistry and then coming up with the final list of safe AAAs along with appropriate stress management drugs needed for optimal patient care. This logical protocol of care thus helps prevent medical emergencies from occurring in the dental setting.

As we see a surge in patients being more medically compromised and living longer, this form of patient care should be the present trend and very definitely the trend of the future.

Question: What did you enjoy most about compiling this guide?
Kanchan Ganda: Creating an easily understood blending of medicine with dentistry and demonstrating that it can and should become the way patients are treated in the dental setting.

Question: Could you offer readers any tips to make the best use of the guide?
Kanchan Ganda: The reader will benefit most by first reviewing the initial sections on patient assessment; medications; stress management and prevention of medical emergencies in the dental setting before moving on to the discussion of specific disease states.

Kanchan Ganda is the Director of Medicine at Tufts Dental School and is responsible for the creation, implementation and co-ordination of teaching dental students. Additionally, she acts as Medical Consultant for all medically complex patients seen in the Tufts Dental Clinics. She also oversees the prevention and care of medical emergencies and personally lectures in continuing education courses to faculty and outside practitioners.