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Essential Dental
Therapeutics
 Essential
Dental
Therapeutics
Edited by
David Wray
University of Glasgow
UK
This edition first published 2018
© 2018 John Wiley & Sons Ltd

All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any
means, electronic, mechanical, photocopying, recording or otherwise, except as permitted by law. Advice on how to obtain permission
to reuse material from this title is available at http://www.wiley.com/go/permissions.

The right of David Wray to be identified as the author of this work has been asserted in accordance with law.

Registered Office(s): John Wiley & Sons, Inc., 111 River Street, Hoboken, NJ 07030, USA
John Wiley & Sons Ltd, The Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, UK

Editorial Office: 9600 Garsington Road, Oxford, OX4 2DQ, UK

For details of our global editorial offices, customer services, and more information about Wiley products visit us at www.wiley.com.

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versions of this book may not be available in other formats.

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The contents of this work are intended to further general scientific research, understanding and discussion only and are not intended
and should not be relied upon as recommending or promoting scientific method, diagnosis or treatment by physicians for any
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Library of Congress Cataloging-in-Publication Data

Names: Wray, David, author.

Title: Essential dental therapeutics / by David Wray.
Description: First edition. | Chichester, West Sussex ; Hoboken : Wiley,
2018. | Series: Essentials | Includes index. |
Identifiers: LCCN 2017014504 (print) | LCCN 2017015962 (ebook) | ISBN
9781119057413 (pdf ) | ISBN 9781119057420 (epub) | ISBN 9781119057390 (pbk.)
Subjects: | MESH: Dental Care | Drug Therapy
Classification: LCC RK51.5 (ebook) | LCC RK51.5 (print) | NLM WU 29 | DDC
617.6–dc23
LC record available at https://lccn.loc.gov/2017014504

Cover design: Wiley

Cover image: © Vstock LLC/ Gettyimages

Set in 10/12pt, AGaramondPro by SPi Global, Chennai, India.

10 9 8 7 6 5 4 3 2 1
Contents
List of contributors vii
Preface ix
About the companion website xi

1 Introduction to pharmacology and therapeutics – pharmacodynamics 1

Alan Nimmo
2 Introduction to pharmacology and therapeutics – pharmacokinetics 7
Alan Nimmo
3 Introduction to pharmacology and therapeutics – drug safety 15
Alan Nimmo
4 Antimicrobials – antiseptics and disinfectants 23
Martina Shepard
5 Antimicrobials – antibiotics 31
Esther Hullah
6 Antimicrobials – antifungals 41
John Steele and Jenny Taylor
7 Antimicrobials – antivirals 47
John Steele and Jenny Taylor
8 Therapeutics of pain management 53
Roddy McMillan
9 Corticosteroids 65
Jenny Taylor and John Steele
10 Fluoride and toothpaste 69
Sabine Jurge
11 Treatments for dry mouth 73
Roddy McMillan
12 Therapeutics for medical emergencies in dental practice 77
Roddy McMillan
13 Central nervous system 1 – mood disorders 85
Alan Nimmo
vi / Contents

14 Central nervous system 2 – neurodegenerative and acquired disorders 93

Alan Nimmo
15 Central nervous system 3 – genetic and developmental disorders 101
Alan Nimmo
16 Endocrine disorders 1 109
Alan Nimmo
17 Endocrine disorders 2 – diabetes mellitus 117
Alan Nimmo
18 Cardiovascular therapeutics 125
Roddy McMillan
19 The respiratory system 137
Martyn Ormond
20 Coagulation 145
Martina Shepard
21 Gastrointestinal pharmacology 153
Esther Hullah
22 Antineoplastic therapeutics 159
Jenny Taylor and John Steele
23 Vitamins and minerals 167
Sabine Jurge
24 Musculoskeletal therapeutics 175
Martyn Ormond

Index 181
List of contributors

Dr. Esther A. Hullah, BDS, MB ChB, MFDS RCS Eng, FDS (OM) RCS Eng, FHEA., Consultant and
Specialist in Oral Medicine, Department of Oral Medicine, Guy’s and St Thomas’ NHS Foundation Trust
& Honorary Lecturer in Oral Medicine, Kings College London Dental Institute, Guy’s Hospital, London,
United Kingdom
Dr Sabine Jurge, DDS, MSc, MBBS, MFDS RCS Eng, FDS (OM) RCPS, FHEA., Consultant and
Specialist in Oral Medicine, Charles Clifford Dental Hospital, Sheffield Teaching Hospitals NHS Foundation
Trust & Honorary Senior Clinical Lecturer in Oral Medicine, The School of Clinical Dentistry University
of Sheffield, London, United Kingdom
Dr. Roddy McMillan, BDS, MB ChB, MFDS RCS Eng, FDS (OM) RCPS, FHEA., Consultant & Specialist
in Oral Medicine, Eastman Dental Hospital, University College London Hospitals NHS Trust & Honorary
Clinical Teaching Fellow in Oral Medicine and Facial Pain, Eastman Dental Institute, University College
London, London, United Kingdom
Professor Alan J. Nimmo, PhD, BSc(Hons)., Professor of Medical Science, College of Medicine and
Dentistry, James Cook University, Smithfield Campus, Cairns, Australia
Dr. Martyn Ormond, BDS, MBBS, MFDS RCS Ed., Specialty Registrar in Oral Medicine, Department
of Oral Medicine, Guy’s and St Thomas’ NHS Foundation Trust & Honorary Lecturer in Oral Medicine,
Department of Oral Medicine, Kings College London Dental Institute, Guy’s Hospital, London, United
Kingdom
Dr. Martina K. Shephard, BDent(Hons), MBBS(Hons), FRACDS, FDS (OM) RCS Eng., Consultant &
Specialist in Oral Medicine, Eastman Dental Hospital, University College London Hospitals NHS Trust,
London, United Kingdom
Dr. John C. Steele, BDS, MB ChB, MFDS RCS Ed, FDS (OM) RCS Ed, Dip OM, PGCTLCP, FHEA.,
Consultant & Specialist in Oral Medicine, The Leeds Teaching Hospitals NHS Trust & Honorary Senior
Lecturer in Oral Medicine, Leeds Dental Institute, Faculty of Medicine & Health, University of Leeds,
London, United Kingdom
Dr Jennifer Taylor, BDS, MB ChB, MFDS RCS Ed, FDS (OM) RCPS., Consultant and Specialist in
Oral Medicine, Greater Glasgow and Clyde NHS Trust, &, Honorary Senior Lecturer in Oral Medicine,
University of Glasgow, Glasgow Dental Hospital and School, 378 Sauchiehall Street, Glasgow, United
Kingdom
Professor David Wray, MD(Hons), BDS, MB ChB, FDS RCPS, FDS RCS Ed, F Med Sci., Emeritus
Professor, University of Glasgow, University Avenue, Glasgow, United Kingdom
Preface

Dentists, along with medical practitioners, are allowed to prescribe all medications although dentists must
prescribe only within their competence as part of their clinical practice. Dentists, working within the National
Health Service, are restricted to prescribing only those drugs included in the dental list and they must only
prescribe generically.
Although the range of medications prescribed by dentists is narrower than their medical counterparts,
dentists prescribe drugs to patients with a wide range of medical conditions who may be taking a number of
other medications, which will influence dental practice as well as potentially causing interactions among the
prescribed drugs.
For these reasons dentists must not only be familiar with the conditions they prescribe for and the drugs
they prescribe but also they must be knowledgeable about general medical conditions affecting their patients
and have knowledge of the drugs these patients may be concurrently taking.
To this end this textbook, designed to inform both dental students and dental practitioners, aims to
provide information about dental prescribing and also general medical conditions, the drugs used to treat
them, and their impact on dental practice.
This text does not cover the competencies required by the prescriber since these are detailed in the recently
published Prescribing Competency Framework, produced the Royal Pharmaceutical Society under the aegis
of NICE. The competencies contained in this Framework should be accomplished by all practitioners seeking
to prescribe safely.
Similarly, this text does not detail specific prescribing details. These are comprehensively included in the
British National Formulary and the British National Formulary for Children which are updated electronically,
monthly and published in hard copy bi-annually and annually respectively. All prescribers should make
reference to these sources when prescribing.
A specific, abridged text, Drug Prescribing for Dentistry, is produced by the Scottish Dental Clinical
Effectiveness Programme (SDCEP.org.uk), which is also available as an iPhone app (https://itunes.apple.com/
gb/app/sdcep-dental-prescribing/id509188306?mt=8). This provides explicit prescribing information for all
drugs on the dental list and is designed to help dentists in primary care practice.
About the companion website

This book is accompanied by a companion website:

www.wiley.com/go/wray/dental-therapeutics

This website contains a set of multiple-choice questions for every chapter for students’ use.
 1

CHAPTER 1

Introduction to
pharmacology and
therapeutics –
pharmacodynamics
Alan Nimmo

Key Topics
◾ Introduction to therapeutics – pharmacodynamics and the basis for drug action
◾ Molecular targets for drug action – receptors, enzymes, ion channels and carrier
proteins
◾ Selective toxicity – the basis of antibacterial, antiviral and antifungal drug action,
and cancer chemotherapy

Learning Objectives
◾ Be familiar with the main types of functional protein that serve as the molecular
targets for drug action
◾ Be aware that in most cases, altering the activity of these proteins alters
chemical signaling in the body, and hence control of body function
◾ Be familiar with how drugs, such as antibiotics, are able to exert a selectively
toxic effect
◾ Be aware of the challenges posed in developing antiviral drugs and drugs for the
treatment of cancer

Essential Dental Therapeutics, First Edition. Edited by David Wray.

© 2018 John Wiley & Sons Ltd. Published 2018 by John Wiley & Sons Ltd.
Companion Website: www.wiley.com/go/wray/dental-therapeutics
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