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Risk Management Strategies for Reducing Oral Adverse Drug Events
Institution:1. Division of Dental Public Health and Pediatric Dentistry, Ostrow School of Dentistry of USC, Los Angeles, CA 90089-0641, USA;2. National Center for Dental Hygiene Research & Practice, Ostrow School of Dentistry of USC, Los Angeles, CA 90089-0641, USA;1. University of Chicago Medical Center, MC5084, 5841 S. Maryland Ave, Chicago, IL 60637, USA;2. Inserm, U678, Laboratoire d''Imagerie Fonctionnelle, 75013, Paris, France
Abstract:Oral adverse drug effects negatively impact oral health, comfort and function.BackgroundPatients treated in the oral health care environment take multiple medications, many of which cause oral complications. Dental professionals are challenged with making recommendations to prevent or minimize drug-induced oral disease risks, while reducing symptoms to improve oral health quality of life.MethodsThis paper presents a critical analysis of current evidence regarding common oral adverse drug events, and reviews existing clinical practice guidelines based upon findings from published systematic reviews.ResultsThere is a lack of sufficient, high quality evidence to support most recommendations for interventions to relieve signs and symptoms of drug-induced oral adverse events. Existing recommendations are largely based on data obtained from observational studies and case reports, and from randomized controlled clinical trials with significant design flaws and potential reporting bias. Outcome measures, especially those related to symptom relief and long-range benefits, are either insufficient or lacking.ConclusionsOral adverse drug effects are a common problem, and additional data is needed to support best practices for product recommendations to improve oral health in medicated patients.
Keywords:Oral adverse drug events  xerostomia  drug-induced ulceration  mucositis  lichenoid drug reaction
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