A Pharmacist's Guide to OTC Therapy: Oral Care Products

Although its value is often underestimated, practicing good oral hygiene is a fundamental component of overall health. Individuals with poor

oral hygiene are at an increased risk of developing various oral health problems. Improper oral hygiene is the direct cause of dental caries, periodontal disease, halitosis, and discomfort for denture wearers.¹

Dental Caries

Dental caries affect an estimated 20% of the population, and individuals at risk for the development of dental caries are those with orthodontic appliances, gum tissue recession that exposes root surfaces, and xerostomia.¹Controlling plaque is fundamental in preventing the incidence of dental caries, and the most efficacious means of ensuring healthy teeth and gingival tissue is to mechanically remove the buildup of plaque by brushing twice a day and flossing at least once a day.¹

Periodontal Disease

Periodontal disease can range from gingivitis, which is reversible and is the mildest form of periodontal disease, to more severe cases known as periodontitis, which can result in irreversible major damage to soft tissue and bone structure of the teeth and is considered to be the primary cause of tooth loss among adults older than 45 years of

age.¹ Furthermore, several studies suggest that periodontal disease may exacerbate certain health conditions including stroke, cardiovascular disease, respiratory disease, and preterm, low-weight babies.² Mechanically removing plaque buildup by brushing at least twice a day and flossing daily also is the best way to prevent gingivitis.

Patients can be at increased risk of developing gingivitis during puberty and pregnancy due to hormonal changes, as well as while taking medications such as calcium channel blockers, cyclosporine, and phenytoin.¹ In addition, those taking anticholinergics and antidepressants are more susceptible due to the decreased flow of saliva.¹

Halitosis

Approximately 90% of all cases of halitosis are directly related to poor hygiene.¹ Prevention of halitosis involves the removal of plaque and the prevention of calculus formation.¹ Patients with severe cases of halitosis or those with an unidentifiable cause should be referred to a dentist for further evaluation.

Proper Oral Hygiene

The goal of proper oral hygiene is the removal or prevention of plaque and tartar buildup, prevention of dental caries and gingivitis, as well as decreasing the incidence of halitosis. A plethora of oral care products are currently available that can meet the needs of many patients. These products are available in various formulations of dentifrices, which include antiplaque/antigingivitis, tartar control, sensitive teeth, whitening products, various flossing products, and topical fluoride products, as well as cosmetic and therapeutic mouth rinses. Various products, which encourage and aid in improving brushing techniques among children, are also available to meet the needs of the pediatric population. In addition to these products, a wide variety of plaque removal devices, such as manual and electric toothbrushes, dental flosses, and oral irrigating devices, can be used for plaque removal.

Pharmacists are in a crucial position to increase awareness regarding the benefits of good oral health care and to emphasize the importance of adhering to a daily preventive oral care regimen, as well as being a source of information for patients on the selection and proper use of these OTC oral hygiene care products. Through routine monitoring, pharmacists have a vital role in recognizing patients who may be susceptible to dental problems associated with the use of some pharmacologic agents and certain medical conditions. Pharmacists should always refer patients to seek advice from a dental professional when warranted. Because many medications can cause varying degrees of adverse dental effects, such as xerostomia, tooth discoloration, abnormal bleeding, or inflammation of the gum tissue, pharmacists also can use patient counseling sessions as an opportunity to remind patients about the importance of adhering to good daily oral hygiene practices as a means of reducing or preventing further complications and ensuring that patients understand the proper use of oral hygiene products.