Drug interactions and prescription safety of the elderly in dentistry

The global demographic transition toward an aging society introduces complex clinical challenges in dental practice, specifically regarding the management of polypharmacy in elderly patients with multiple chronic comorbidities. This pharmacological complexity significantly increases the incidence of potential drug-drug interactions, which are associated with elevated risks of therapeutic failure and severe adverse drug reactions. Epidemiological data indicate a 40.7% prevalence of drug-drug interactions in dental patients, with a markedly higher interaction problem observed in individuals with cardiovascular disease. Despite the clinical significance, dentist’s recognition of these interactions is documented at 42.7%, indicating a critical gap in pharmacological surveillance. Age-related physiological alterations, including diminished glomerular filtration rates and altered distribution volumes, necessitate function-based dose titrations to prevent drug accumulation and toxicity. Specific dental pharmacotherapeutics, mainly non-steroidal anti-inflammatory drugs, antibiotics such as macrolides, and vasoconstrictors, demonstrate high-risk profiles when co-administered with systemic anticoagulants, beta-blockers, or antidepressants. Clinical safety in geriatric dentistry requires a systematic approach encompassing comprehensive medication history review, the utilization of web-based or application screening tools, dose individualization based on renal and hepatic function, and interprofessional collaboration to optimize individualized prescribing strategies. This systematic approach is essential for optimizing patient safety in an aging society.