The medical history questionnaire is frequently completed hurriedly and regarded as administrative. Several classes of medication materially alter surgical planning, and omissions are not without consequence.
Antiresorptive agents
Bisphosphonates and denosumab, prescribed for osteoporosis and for certain oncological indications, are associated with medication-related osteonecrosis of the jaw following oral surgery.
Risk is low with oral formulations for osteoporosis and substantially higher with intravenous administration in oncological contexts. Duration of therapy is relevant, and patients frequently do not recall having received these agents, particularly annual infusions.
Anticoagulants and antiplatelet agents
Contemporary guidance generally advises against interrupting anticoagulation for routine dental surgery, since thromboembolic risk exceeds bleeding risk. Local haemostatic measures are usually sufficient.
The clinically relevant information is which agent, at what dose, and for what indication. Unilateral discontinuation by the patient before an appointment is hazardous and should never be undertaken without instruction.
Immunosuppressants, corticosteroids and diabetes management
These influence healing and infection risk, and may indicate modification of antibiotic protocols or timing. Glycaemic control, expressed as glycated haemoglobin, correlates with implant outcome and warrants specific enquiry.
Other relevant categories
Antidepressants including SSRIs have been associated in some literature with altered bone metabolism. Anticonvulsants may produce gingival overgrowth. Supplements affecting coagulation are frequently omitted from questionnaires because patients do not classify them as medication.
Provide the complete list, including non-prescription preparations and supplements, and identify the prescribing physician. Where indicated, direct consultation with that physician forms part of appropriate planning.
For an individual assessment of your case, you can request a consultation at our Bogotá practice.
