Pharmacology Declassified

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Pharmacology Declassified

See my personal FB page TomViolaRPh for more information! With over 30 years’ experience as a pharmacist, dental educator and author, Tom Viola, R.Ph., C.C.P.

has earned his national and international reputation as the go-to specialist for delivering quality dental continuing education content through his informative, humorous and engaging presentations. Tom’s sellout programs provide an overview of the most prevalent oral and systemic diseases and the most frequently prescribed drugs used in their treatment, along with specific focus on dental considerations and strategies for implementing effective care plans. Learn more: http://www.tomviola.com/

09/04/2026

Is kissing your dog bad for your health?

As someone who will happily accept a kiss from just about any dog, I was very invested in this one. 😂

The answer? For most healthy adults, the risk is probably pretty low — but that doesn’t mean dog saliva is exactly sterile.

Dogs carry bacteria in their mouths just like we do. Some organisms found in dog saliva can cause infection, particularly if they get into broken skin, a wound, or a healing surgical site.

And yes, some bacteria associated with dogs can also be connected to periodontal disease.

So should you panic every time your dog licks your face?

Probably not.

But there are a few situations where I’d be a little more cautious:

🐶 If you’re immunocompromised or taking medications that suppress your immune system
🐶 If you have an open wound or healing surgical site
🐶 If your dog has poor oral health
🐶 If you just watched your dog drink out of the toilet, investigate the garbage, or sample some mysterious lake water 😬

And one thing I definitely wouldn’t recommend: letting your dog lick a dental surgical site because you think saliva will help it heal.

That may be a cultural belief in some places, but from an infection-control standpoint, it’s not a great idea.

The bigger takeaway is pretty simple:

Keeping your dog healthy helps keep you healthy, too.

Regular veterinary care, good oral hygiene for your dog, and a little common sense go a long way.

So… am I still going to kiss my dog?

Absolutely.

Maybe just not immediately after I see where that tongue has been. 😂

09/02/2026

Why are we suddenly seeing so many younger patients — and more women — taking medications for hair loss?

Because the way people think about hair loss has changed.

For years, many people waited until they started losing hair to do something about it. Now, more patients are taking a preventive approach and using medications earlier in an effort to maintain the hair they have.

That means dental professionals may start seeing medications like **minoxidil, spironolactone, and finasteride** show up on medical histories more often.

And here’s where it gets important for us:

Don’t assume you know why the patient is taking the drug.

Spironolactone may be used for hypertension, acne, or hair loss. Finasteride may be used for benign prostatic hyperplasia or hair loss. Minoxidil may be used topically for hair growth, but some patients may also be taking low-dose oral formulations.

Same drug. Very different reason.

And regardless of *why* they’re taking it, some of these medications can still affect blood pressure and contribute to dizziness, orthostatic hypotension, or that lovely feeling where you turn your head and the room takes a second to catch up with you. 😵‍💫

Now put that patient in a dental chair.

They’ve been supine for an hour. You sit them upright. You may also have used local anesthetic with epinephrine.

Suddenly, knowing that “hair loss medication” is on the medical history matters a little more.

So when you see a medication you recognize, don’t stop at the name.

Try:

“I see you’re taking finasteride. Tell me about it.”

No judgment. No assumptions. Just a conversation.

Then get the rest of the information we always need:

💊 Why are you taking it?
💊 How much are you taking?
💊 Did you take it today?

Because patients may not always be comfortable explaining why they take a medication — especially when it involves something like hair loss.

The goal isn’t to make them uncomfortable. It’s to understand the medication well enough to treat them safely.

08/31/2026

**PCOS, PMOS… and what does any of this have to do with dentistry? More than you might think.**

In a recent episode of **Medical History Mysteries**, Dr. Pam Maragliano-Muniz and I talked about the broader metabolic and hormonal picture traditionally associated with polycystic ovarian syndrome — and why dental professionals should care about the systemic clues that may show up in our chairs.

We tend to think of PCOS as an ovarian condition. But the conversation around it has expanded because the effects can reach far beyond the reproductive system.

**Insulin resistance. Type 2 diabetes. Hypertension. Cardiovascular risk. Hormonal changes.**

Those are all things that can matter very much in dentistry.

And here’s where I think dental professionals have an incredible opportunity.

We see our patients regularly. We take blood pressures. We review medical histories. We perform head and neck exams. We notice changes that may have happened slowly enough that the patient hasn’t noticed them at all.

Maybe a younger patient suddenly has elevated blood pressure.

Maybe there are signs that make you wonder about blood glucose control.

Maybe something in their health history just doesn’t fit the pattern you would normally expect.

**That doesn’t mean we diagnose the condition.**

It means we recognize when something deserves a closer look and encourage that patient to follow up with their medical provider.

That’s also why I keep preaching about baseline vital signs. If you’ve taken a patient’s blood pressure consistently for years and suddenly it’s significantly different, you have context. Without that baseline, you may miss an important change.

Dentistry gives us something incredibly valuable: **continuity of care.**

Sometimes we’re the fresh set of eyes that notices something a patient didn’t know was happening.

And I’ll say it every chance I get: **dental professionals save lives every day.** You may never get the phone call saying, “You were the reason I got this checked out,” but that doesn’t make the impact any less real.

08/28/2026

**True story or fake news: ma*****na should not be prescribed for anxiety, depression, or PTSD?**

This is one of those topics where the answer is a lot more complicated than the conventional wisdom.

Cannabis has a reputation for helping people “mellow out,” and plenty of patients report that it helps them with anxiety, sleep, PTSD, or depression.

But research published in **The Lancet Psychiatry** raised an important concern: we still don’t have rigorous evidence showing that cannabis or medical cannabinoids effectively treat anxiety, depression, or PTSD. And in some cases, cannabis products may actually worsen symptoms or delay treatments that have stronger evidence behind them.

That doesn’t mean someone’s personal experience isn’t real.

It means **anecdotal evidence and clinical evidence aren’t the same thing.**

One of my biggest concerns is self-treatment.

If someone feels anxious, depressed, or unable to sleep and cannabis helps relieve that symptom, it can be tempting to stop there. But what if that symptom is part of a larger condition that hasn’t been diagnosed?

You may be treating the symptom while the underlying problem continues to progress.

And there’s another wrinkle: **THC concentration matters.** Higher concentrations can increase the likelihood of effects such as anxiety, paranoia, and hyperactivity — some of the very symptoms a person may have been trying to manage in the first place.

So what does all of this mean for dental professionals?

We don’t need to become mental health specialists. But we **do** need to know what our patients are using, why they’re using it, and whether they’re receiving appropriate medical guidance and monitoring.

Cannabis is changing quickly — the products, the research, and the regulations surrounding it.

That’s why I always say: stay frosty. 😎

Our patients may know a lot about the cannabis products they use. We need to make sure we understand enough to ask the right questions and recognize when a conversation with their medical provider may be appropriate.

*****na

08/26/2026

**Can dermal filler mimic a dental infection? Turns out, yes — and that can send us down quite the diagnostic rabbit hole.**

When a patient presents with facial swelling, jaw pain, or what looks like an abscess, our first instinct is naturally to look for a dental cause.

But dermal fillers can complicate that picture.

Some fillers can develop **dormant biofilms** that may become activated after dental procedures, creating inflammation that can look and feel a lot like an odontogenic infection. Fillers can also create imaging artifacts, which means even our radiographs may not give us the clean answer we’re expecting.

And there’s another piece dental professionals should have on their radar: certain cosmetic procedures involving hyaluronic acid fillers have also been associated with localized bone resorption.

So now imagine this scenario:

Your patient comes in with swelling.
It looks dental.
The imaging is unusual.
The tooth tests don’t point to a clear source.
You refer them. The specialist is puzzled too.

Meanwhile, nobody has asked the question that might completely change the diagnostic path:

**“Have you had any cosmetic procedures recently?”**

That may need to become part of our medical history conversation.

We already ask:
What do you take?
Why do you take it?
Did you take it today?

Maybe we need to add:

**Have you had any recent procedures — including cosmetic procedures, fillers, Botox, or surgery?**

Because patients may not think of dermal filler as a “medical procedure,” especially if it wasn’t performed in a traditional medical setting.

The point isn’t that every unusual swelling is related to filler. The point is that **we need to know this possibility exists** so we don’t spend weeks chasing the wrong diagnosis.

Dr. Pam Maragliano-Muniz and I get into this one on **Medical History Mysteries.** 🔎🦷

Sometimes one extra question on the medical history can completely change where the diagnostic road leads.

08/24/2026

**What exactly are “gas station drugs” — and why should dental professionals care?**

You can buy a lot more than coffee and snacks at some convenience stores these days. Products containing substances like **tianeptine, kratom, concentrated 7-hydroxymitragynine, and synthetic cannabinoids such as delta-8 or delta-10** may be sitting right on the shelf.

And just because something is easy to buy doesn’t mean it’s harmless.

Some of these substances can have opioid-like or stimulant effects, may carry risks of dependence or overdose, and — particularly important for us in dentistry — may interact with medications we use during treatment.

Here’s the part I really want dental professionals to think about:

**Would your patient even consider mentioning one of these products on their medical history?**

If we simply ask, “What medications are you taking?” the answer might not include the pill they bought at a gas station, the kratom they use occasionally, or the delta-8 product they took before their appointment to “take the edge off.”

That’s why the language we use matters.

Ask specifically about **prescription medications, over-the-counter products, supplements, cannabis products, and other recreational or psychoactive substances.** And document the answer.

If a patient says they don’t use substances, your chart shouldn’t just leave the section blank. Document that **the patient denies substance use.**

That little sentence shows two important things: you asked the question, and you documented their answer.

Because sometimes the most important medication on a patient’s medical history is the one they don’t think is a medication at all.

Dr. Pam Maragliano-Muniz and I unpack this one on **Medical History Mysteries.** 🔎💊

08/21/2026

**The weight is over?** 😎

GLP-1 and GIP medications like Ozempic, Wegovy, Mounjaro, and Zepbound have become a huge part of the conversation around diabetes and weight management — but what do they mean for us in dentistry?

In my webinar, **“The Weight Is Over? GLP-1 Drugs and What They Mean for Dentistry,”** I break down what dental professionals need to know about these medications and, more importantly, how they may influence the way we treat our patients.

We’ll talk about:

💊 The medications used to manage diabetes mellitus
💉 How GLP-1/GIP agonists work and why their use has exploded
🦷 The dental considerations that can come along with these medications
📋 Treatment-planning strategies for patients taking GLP-1/GIP drugs

Because when a patient says, “Oh, and I’m taking one of those weight-loss shots…” there’s a little more we need to know. 😉

The medications may be changing quickly, but the goal stays the same: **know what your patient is taking, understand why they’re taking it, and know what it means for the care you provide.**

Learn more: https://www.mouthwatch.com/resources/glp-1-drugs-and-dentistry?utm_campaign=feed&utm_medium=referral&utm_source=later-linkinbio

08/20/2026

I’m teaming up with the incredible Dr. Kelly Tanner for a conversation I think **every member of the dental team needs to hear.**

We’re talking about **Asthma/COPD Inhalers: Caries, Candidiasis, and Appointment Readiness** — because what an inhaler does *outside the lungs* can have a very real impact on the way we plan treatment, prevent complications, and care for our patients.

Kelly is bringing the dental hygiene perspective, I’m bringing the pharmacology, and together we’re going to connect the dots in a practical, podcast-style conversation you can actually use in practice.

And yes… you’ll earn CE while you’re at it. 😎

🗓 **August 25, 2026 | 7–8 PM EST**
📍 Live Webinar
🎓 1 hour of PACE-approved CE

Bring the whole team!

🔗 Register now at www.rarebirddentalce.com](http://www.rarebirddentalce.com

08/10/2026

A patient may answer “no” when asked whether they take any medications—and still have used kratom, 7-hydro, delta-8, tianeptine, or another psychoactive product before their appointment.

They may not consider it a medication. They may call it a supplement, a wellness product, or something they picked up at a gas station. But that substance could still interact with medications used during dental treatment.

That becomes especially important when a procedure involves sedation, pain management, or local anesthetics. Combining substances that affect the central nervous system may increase sedation or respiratory risks, while other products may affect cardiovascular response or interact with the patient’s prescriptions.

This is why the wording of the medical history matters. Ask directly about:

• Prescription medications
• Over-the-counter products
• Vitamins and supplements
• Cannabis and synthetic cannabinoids
• Kratom, 7-hydro, and other recreational substances
• Anything taken to relax before the appointment

Then document the answer. Writing “patient denies the use of substances” shows both that the question was asked and how the patient responded.

Sometimes getting more information—or rescheduling treatment—is the safest clinical decision.

Watch the full episode of “Medical History Mysteries” on DentistryIQ.com.

08/06/2026

Is berberine really “nature’s Ozempic”? Not exactly.

Berberine may offer modest benefits for blood sugar and metabolic health, but the evidence does not support comparing it to prescription GLP-1 medications. More importantly for dental professionals, this popular supplement can affect how the body processes commonly used medications.

Berberine may interfere with CYP enzymes involved in metabolizing drugs such as codeine and tramadol. That means a patient’s postoperative pain medication may not work as expected. Because berberine can also lower blood sugar, combining it with insulin, metformin, or other diabetes therapies may increase the risk of hypoglycemia.

Yes, berberine has shown antimicrobial activity against certain oral pathogens—but “natural” does not automatically mean harmless or interaction-free.

This is why our medication history conversations must go beyond prescriptions. Ask every patient:

“What do you take?”
“Why do you take it?”
“Did you take it today?”

And be sure they know that supplements, powders, gummies, and other wellness products count, too.

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