Oral Herpes, Within a Dentist's scope?

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Herpes within scope?

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npage148

npage148

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Had an Rx for acyclovir for herpes (cold sores) from a dentist tonight. Do you think this is within his scope? Personally, I think it's boarderline
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Dentists treat diseases of the mouth. Oral herpes is in the mouth. By the way Sparda, if you didn't fill rxs written by doctors who had no clue about what they are writing, you wouldn't fill any rxs at all....
 
So is the dentist going to tell their patient not to have oral sex when they have sores? Would they go on to tell them how to prevent outbreaks and tell them to use condoms or dental dams for safe sex? Just curious...I mean, isn't there more to go along with writing a script out for acyclovir to treat herpes?
 
rxlea said:
So is the dentist going to tell their patient not to have oral sex when they have sores?
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I would assume so. But it's silly to assume a dentists can treat a bacterial infection in the mouth but not a viral infection. Dentists perform difficult surgeries, grow artificial bone, place implants. To assume they can't treat an oral viral infection is silly....
 
Old Timer said:
I would assume so. But it's silly to assume a dentists can treat a bacterial infection in the mouth but not a viral infection. Dentists perform difficult surgeries, grow artificial bone, place implants. To assume they can't treat an oral viral infection is silly....
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Well, admittedly, I don't know that much about what dentists can and cannot do. I usually only have a yearly cleaning haha good learning opportunity here, though. Thanks.
 
Old Timer said:
Dentists treat diseases of the mouth. Oral herpes is in the mouth. By the way Sparda, if you didn't fill rxs written by doctors who had no clue about what they are writing, you wouldn't fill any rxs at all....
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:thumbup:

I had dental surgery last month where the dentist removed strips of my pallet and grafted it to my gums. For rxs I received T#3, Toradol (he told me to take the t#3 and the toradol alternately, which was kind of weird), and amoxicillin. So why would acyclovir be beyond the scope of a dentist?
 
I just think it would be silly for a pharmacist to refuse to fill this, especially from the perspective of a customer (well not really since I do not have herpes so I wouldn't know what it's like). I think this is when those "I'm going to a pharmacy that actually fills prescriptions" comments are slightly appropriate.
 
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npage148 said:
Had an Rx for acyclovir for herpes (cold sores) from a dentist tonight. Do you think this is within his scope? Personally, I think it's boarderline
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It's borderline but it's not exactly a drug of abuse. I'd be comfortable filling it.
 
I think dentists know enough to prescribe acyclovir. It's oral...I vote yes. If they tried prescribing Ativan I might wonder.
 
jinga said:
I think dentists know enough to prescribe acyclovir. It's oral...I vote yes. If they tried prescribing Ativan I might wonder.
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Of course they can prescribe it. They can prescribe Ativan for those who get nervous going to the dentist's office.

When I was little, i used to get painful canker sores. I saw a physician who said it was just due to my teeth being too sharp... I saw a dentist who explained it a lot better. Dentists are so much more knowledgeable about mouth related problems.
 
Sparda29 said:
Ehh, it's borderline but I wouldn't fill it. Especially after that joke dentist who called in Cipro 3 grams QID.
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Are u a troll or are you really that dumb
 
Pharmavixen said:
:thumbup:

I had dental surgery last month where the dentist removed strips of my pallet and grafted it to my gums. For rxs I received T#3, Toradol (he told me to take the t#3 and the toradol alternately, which was kind of weird), and amoxicillin. So why would acyclovir be beyond the scope of a dentist?
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i also had this procedure about 3-4 years ago. the two shots in the pallet were absolutely terrible.
 
I think it's ok to fill a script like that once or twice (sort of like urgent care), but frequent oral herpes outbreaks need to be evaluated and treated by a PCP, infectious disease specialist, or dermatologist. Would a dentist know how to treat resistance?

A check-up by a gynecologist wouldn't be a bad idea either. ;)
 
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Sosumi said:
Of course they can prescribe it. They can prescribe Ativan for those who get nervous going to the dentist's office.

When I was little, i used to get painful canker sores. I saw a physician who said it was just due to my teeth being too sharp... I saw a dentist who explained it a lot better. Dentists are so much more knowledgeable about mouth related problems.
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Hello...??? Canker sores are on the gums inside the mouth. We're talking about cold sores, which are around the mouth and on the face.
 
Sosumi said:
Of course they can prescribe it. They can prescribe Ativan for those who get nervous going to the dentist's office.

When I was little, i used to get painful canker sores. I saw a physician who said it was just due to my teeth being too sharp... I saw a dentist who explained it a lot better. Dentists are so much more knowledgeable about mouth related problems.
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Couldn't they just use nitrous?
 
PharmDstudent said:
Hello...??? Canker sores are on the gums inside the mouth. We're talking about cold sores, which are around the mouth and on the face.
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I know that :mad: My point is that my experience with dentists are that they are experts on oral diseases. Knowing whether to prescribe acyclovir or valacyclovir for cold sores doesn't require much expertise.
 
Sosumi said:
I know that :mad: My point is that my experience with dentists are that they are experts on oral diseases.
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How is it an 'oral' disease? It's a skin disease... in the case of cold sores; that's the reason it's up for debate.
Sosumi said:
Knowing whether to prescribe acyclovir or valacyclovir for cold sores doesn't require much expertise.
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Ha! That's what you think. I knew a dentist who didn't know the dosing for Clindamycin po, so I doubt he knows anything about resistant herpes simplex.
 
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oh god, you guys are way too ****ing anal. lay off. its not that big of a deal. why you gotta bust balls about the scope of practice with herpes medication.

its not like he is prescribing heart medication. good god.
 
PharmaTope said:
oh god, you guys are way too ****ing anal. lay off. its not that big of a deal. why you gotta bust balls about the scope of practice with herpes medication.

its not like he is prescribing heart medication. good god.
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It's a debate about scope of practice. If you can't take the heat, get out of the kitchen! :p

If you have lip cancer, are you going to go to a dentist for it? What about oral thrush? What about for the side effects of Accutane (dry, cracked lips)?
 
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PharmDstudent said:
It's a debate about scope of practice. If you can't take the heat, get out of the kitchen! :p

If you have lip cancer, are you going to go to a dentist for it? What about oral thrush? What about for the side effects of Accutane (dry, cracked lips)?
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you went from talking about acyclovir to lip cancer and accutane.

wtf

herpes happens and i see absolutely ZERO issue with accepting that prescription.

and do you know the full scope of dental practice? bc i sure dont ever recall seeing any pharmacy curriculum that is devoted to teaching what the scope of medicine and dentistry is to pharmacists.

i guess your higher calling is stopping the over prescribing of herpes medication by dentists.... ?

you are going on your own personal opinion and bias here about what a dentist does and can diagnose. pretty silly if you ask me.
 
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PharmDstudent said:
Hello...??? Canker sores are on the gums inside the mouth. We're talking about cold sores, which are around the mouth and on the face.
Click to expand...

PharmDstudent said:
How is it an 'oral' disease? It's a skin disease... in the case of cold sores; that's the reason it's up for debate.
Ha! That's what you think. I knew a dentist who didn't know the dosing for Clindamycin po, so I doubt he knows anything about resistant herpes simplex.
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PharmDstudent said:
It's a debate about scope of practice. If you can't take the heat, get out of the kitchen! :p

If you have lip cancer, are you going to go to a dentist for it? What about oral thrush? What about for the side effects of Accutane (dry, cracked lips)?
Click to expand...


Do you see that label below my username as well as your username? It says "pharmacist", get over it. What do you know about the field of dentistry? Don't tell me..."they just clean your teeth and give you a free toothbrush at every visit blah blah blah". Ugh I can't stand this kind of mentality and it's always from people who hate being called "the guy/gal that just counts pills and puts them in a bottle". Stop assuming stuff about other professions and the rest will follow. Like I said, if I heard you refusing an antiviral from a dentist I would laugh and I was a customer wanting to get it filled only to hear no then I would go to a pharmacy that actually fills prescriptions.

:mad:
 
PharmDstudent said:
It's a debate about scope of practice. If you can't take the heat, get out of the kitchen! :p

If you have lip cancer, are you going to go to a dentist for it? What about oral thrush? What about for the side effects of Accutane (dry, cracked lips)?
Click to expand...

Some dental schools, like the one I use to attend, had dental students taking the SAME classes as medical students! So essentially dental students are just as smart as med students. They take the SAME classes with the same professors, why would they be any less? They know more then just teeth and gums...so yes they should be allow to prescribe most drugs.
 
Had a dentist instruct me on the use of klonopin for "burning mouth syndrome". Had to look that one up. Pretty unique stuff. Nonetheless, I don't have an issue filling oral meds for oral disorders from a Doctor of the oral cavity. If they have an explanation, I'll even take rx for abnormal meds for oral disorders I'm not aware of yet.
 
PharmDstudent said:
I think it's ok to fill a script like that once or twice (sort of like urgent care), but frequent oral herpes outbreaks need to be evaluated and treated by a PCP, infectious disease specialist, or dermatologist. Would a dentist know how to treat resistance?

A check-up by a gynecologist wouldn't be a bad idea either. ;)
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Are you as ******ed as Sparda? This is ridiculous. You realize what kind of stuff lives in people's mouths, right? You realize that dentists commonly prescribe antibiotics right? Or the fact that you cannot cure herpes, right? So every time they have an outbreak, its not some new, super resistant strain that was caused by acyclovir use.


DrPepsi said:
Do you see that label below my username as well as your username? It says "pharmacist", get over it. What do you know about the field of dentistry? Don't tell me..."they just clean your teeth and give you a free toothbrush at every visit blah blah blah". Ugh I can't stand this kind of mentality and it's always from people who hate being called "the guy/gal that just counts pills and puts them in a bottle". Stop assuming stuff about other professions and the rest will follow. Like I said, if I heard you refusing an antiviral from a dentist I would laugh and I was a customer wanting to get it filled only to hear no then I would go to a pharmacy that actually fills prescriptions.

:mad:
Click to expand...

People are just looking to be *******s and dying to use their "power."

SHC1984 said:
Some dental schools, like the one I use to attend, had dental students taking the SAME classes as medical students! So essentially dental students are just as smart as med students. They take the SAME classes with the same professors, why would they be any less? They know more then just teeth and gums...so yes they should be allow to prescribe most drugs.
Click to expand...

Exactly, my dentist friends were asking me about diabetes medications that they were learning about. They also learned about, gasp, infectious disease.
 
Dentists are doctors of the oral cavity, not the epidermis or the entire body. I'm not sure what's so hard to understand. :confused:
 
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PharmDstudent said:
Dentists are doctors of the oral cavity, not the epidermis or the entire body. I'm not sure what's so hard to understand. :confused:
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I am assuming the patient didn't go to the dentist for JUST the herpes simplex. Besides, if they are going to a PCP, they have to tell the PCP what they are on and why so unless the patient avoids going to the PCP (and who would rather go to the dentist than a PCP anyway...PCPs don't have drills :laugh:), they are going to get the "care" required to oversee their condition, anyway. I am no pharmacist or pharmacy student yet, but that's what I think...
 
rxlea said:
I am assuming the patient didn't go to the dentist for JUST the herpes simplex. Besides, if they are going to a PCP, they have to tell the PCP what they are on and why so unless the patient avoids going to the PCP (and who would rather go to the dentist than a PCP anyway...PCPs don't have drills :laugh:), they are going to get the "care" required to oversee their condition, anyway. I am no pharmacist or pharmacy student yet, but that's what I think...
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Hopefully they went to the dentist for an office visit, but you never know. The dentist could be the patient's relative or buddy.

I'm not against a couple of fills under the dentist, because I realize that dentists are health professionals, but patients will try to get around proper care (which is beyond my comprehension) to avoid: paying additional copays, paying for lab tests, or the inconvenience of seeing a physician.


OMG! 3,000 posts
 
PharmDstudent said:
Dentists are doctors of the oral cavity, not the epidermis or the entire body. I'm not sure what's so hard to understand. :confused:
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Its well within the scope of practice, I don't know what is so hard to understand. Oral herpes causes painful sores on your lips, gums, tongue, roof of your mouth, and inside your cheeks. I am pretty sure that that has a lot to do with the oral cavity. You fail.

FTW:
http://www.yourdentistryguide.com/oral-herpes/

btw, the inside of your mouth is considered the epidermis even though it is not keratinized skin. It is epithelial in nature, because if you remember your basic anatomy, the GI tract is nothing but a tube that protects the inside of your body.
 
Quiksilver said:
Its well within the scope of practice, I don't know what is so hard to understand. Oral herpes causes painful sores on your lips, gums, tongue, roof of your mouth, and inside your cheeks. I am pretty sure that that has a lot to do with the oral cavity. You fail.

FTW:
http://www.yourdentistryguide.com/oral-herpes/

btw, the inside of your mouth is considered the epidermis even though it is not keratinized skin. It is epithelial in nature, because if you remember your basic anatomy, the GI tract is nothing but a tube that protects the inside of your body.
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The original post says "cold sores", not "canker sores". Cold sores are found on the *skin* outside of the mouth, while canker sores are on the *gums* inside of the mouth.

So a dentist should treat GI tract infections now, too, since you say it's epidermis (just like the inside of your mouth)? :rolleyes: The line has to be drawn somewhere- the oral cavity. That's what 'scope of practice' is all about.


I give up... There are some thick-headed people around here.
 
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PharmDstudent said:
The original post says "cold sores", not "canker sores". Cold sores are found on the *skin* outside of the mouth, while canker sores are on the *gums* inside of the mouth.

So a dentist should treat GI tract infections now, too, since you say it's epidermis (just like the inside of your mouth)? :rolleyes: The line has to be drawn somewhere- the oral cavity. That's what 'scope of practice' is all about.


I give up... There are some thick-headed people around here.
Click to expand...


The point is a dentist knows more a lot more about the OVERALL HUMAN HEALTH AND PHYSIOLOGY then you think. You think the dentist knows nothing besides cleaning and flossing and pulling teeth. :rolleyes: But that isn't true! that's like saying the pharmacist knows nothing, but counting pills. Again, dentists are taking the SAME EXACT classes as medical students so they pretty much know just as much as MDs. They are qualified to do much MUCH more than just pulling teeth and flossing them.

And yes, the dentist would know about GI infections and skin infections/diseases and much more since AGAIN they are taking the SAME classes as med students are.
 
Quiksilver said:
Exactly, my dentist friends were asking me about diabetes medications that they were learning about. They also learned about, gasp, infectious disease.
Click to expand...


I can understand the misconception though. Most people that don't know much about the dental field would think that the dentists are only qualified to 1) clean teeth and 2) pull teeth. Just like people that know nothing about pharmacy believe pharmacist's only job is 1) count pills and 2) fill bottles. :rolleyes:

I would not have known what a dentist is required to know if I hadn't attended dental school myself. Taking classes with med students was a challenge. Dentist is pretty much require to know everything a MD is required to know. Pulling teeth is about 1/10000000000 of the knowledge required.
 
PharmDstudent said:
The original post says "cold sores", not "canker sores". Cold sores are found on the *skin* outside of the mouth, while canker sores are on the *gums* inside of the mouth.

So a dentist should treat GI tract infections now, too, since you say it's epidermis (just like the inside of your mouth)? :rolleyes: The line has to be drawn somewhere- the oral cavity. That's what 'scope of practice' is all about.


I give up... There are some thick-headed people around here.
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blah blah blah. You say that there are thick headed people everytime someone disagrees with you yet I have never seen you be anything but being thickheaded too. Pot meet kettle.

Also canker sores have many causes while cold sores are associated primarily with herpes simplex. Maybe you should do some research before you give your innane opinions.
 
Boys and Girls:

And I am old enough to call you boys and girls. I can call names with the best of them, but this is getting wildly out of hand. While I believe that this is within the scope of practice for a dentist, I can see where others would disagree. I love good strong argument, but hold back on the personal attacks, please......

Remember this is theoretical. When you are in the real world, you better be damn sure before you just turn down an RX cold. You could be dancing before the State Board.
 
This isn't what a dentist could treat or know how, this is what a dentist is legally able to treat. I could treat host of disease states but I'm not legally able too. They deal with the oral cavity, legally does this include the dermal tissue around the mouth? It's not in the oral cavity. Where does this line stop? Can they treat acne around the mouth since it's the same physical area as herpes?

It's worth debating because it's your license on the line. What would happen if they treated it and for some reason the pt died due to the dentists' action (misdiagnosis of something more serious as herpes, drug contraindication, etc). The pharmacist is likely to come under serious fire for filling the RX, especially if it's seen as outside the dentist's scope.
 
npage148 said:
This isn't what a dentist could treat or know how, this is what a dentist is legally able to treat. I could treat host of disease states but I'm not legally able too. They deal with the oral cavity, legally does this include the dermal tissue around the mouth? It's not in the oral cavity. Where does this line stop? Can they treat acne around the mouth since it's the same physical area as herpes?

It's worth debating because it's your license on the line. What would happen if they treated it and for some reason the pt died due to the dentists' action (misdiagnosis of something more serious as herpes, drug contraindication, etc). The pharmacist is likely to come under serious fire for filling the RX, especially if it's seen as outside the dentist's scope.
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Since cold sores can be in the mouth (rare, but not unheard of) I think this is within the scope of practice. You can always call the prescriber and verify the information and act accordingly. I personally would probably fill it especially if the provider or patient were familiar to me.
 
definitely within scope, DMD/DDS students get multiple path courses to ID & tx oral herpes & other dz's, that's good enough for me. though my DMD friend said "i probably wouldn't go near that one...i'd write the script and refer the pt to their PCP."
 
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