Initial health history information should always be collected on new patients, updated every two years, and reviewed and updated at every appointment.1 Patients often forget to report health conditions, surgeries, medications, and allergies because they rush through the questionnaire. They may list medications for high blood pressure (HBP), atrial fibrillation, or diabetes, but fail to mark those conditions on the questionnaire.
Also, some patients assume that because their blood pressure medication is working properly, they no longer have HBP, so they fail to mark it on the form. All this should be caught and corrected immediately on the paperwork and electronic chart. What if a patient forgot to take their medication for days or even weeks, and their blood pressure is dangerously high, and the dental professional is unaware? This may pose a risk and cause a potential emergency in the dental chair, especially if blood pressure is not routinely checked at your office.
Not everyone in the dental office is familiar with drug names and what condition they treat, and conditions may not be caught and marked accurately on the questionnaire and the alert section of the dental software.
For example, propranolol, which goes by many brand names, is often prescribed for HBP, anxiety, arrhythmia, migraines, tremors, and other conditions.2 It has many side effects and drug interactions, including with local anesthetic agents and NSAIDS, and may cause xerostomia.2 This may mean taking extra precautions during treatment, possibly altering treatment and post-operative instructions, and prescribing the appropriate hygiene practices.
The right questions to ask patients
It’s necessary to ask probing questions to find out not only if anything has changed in their health, because the last provider may have missed something, but we should take responsibility to ask the patient at every single appointment what specific medications, supplements, health conditions, and allergies they have, and if they take their medications as prescribed.
Simply asking if anything has changed is not enough.3 We should ask questions such as, “Have there been any recent surgeries or hospitalizations?” “Any heart surgeries or joint replacements” “Any newly diagnosed conditions or allergies?” “Do you have sleep apnea or wear a CPAP?” “What is your most recent A1C number?” “Any chance you may be pregnant?” “Any allergies to medications or anesthetics?” “Do you have any autoimmune conditions?”
Such questions are often not readily asked, and if they are, they’re not always documented in all the appropriate areas of the chart. Having this information may call for treatment modification, premedication, or vasoconstrictor considerations, and may help connect the dots in terms of the oral-systemic link and what we observe in someone’s mouth.3 Mistakes may happen when we’re in a hurry, but as licensed professionals, we must take the time to ensure the safety of our patients as well as the practice.3
Medication awareness and treatment implications
All dental personnel should be familiar with common drug names and the conditions they treat. If you don’t know, do an online search during the appointment, especially due to all the various brand names. People are often in a rush and forget to thoroughly read and answer questions. As professionals, we must slow down, inquire, ask probing questions at every single appointment, and explain to patients why such thoroughness is required.
Certain medications interact with local anesthetics or other drugs the dentist may decide to prescribe. They may affect dental treatment or impact post-operative care instructions. The lack of awareness of patients’ health conditions, medications, or allergies may lead to an unexpected adverse reaction or an emergency that could have been avoided.1
References
- Medical/Dental Health History. American Dental Association. Accessed on August 22, 2025. https://www.ada.org/resources/practice/practice-management/medical-dental-health-history
- Propranolol (oral route). Mayo Clinic. Accessed on August 22, 2025. https://www.mayoclinic.org/drugs-supplements/propranolol-oral-route/description/drg-20071164
- Sanders, KM. The medical history mistake every dental provider makes. May 2, 2018. Accessed on September 1, 2025. https://www.dentalproductsreport.com/view/medical-history-mistake-every-dental-provider-makes
