Dentists, stomatologists and dental hygienists are healthcare professionals responsible for the prevention and treatment of oral problems. However, pharmacists are more accessible, and are therefore often the person people approach to receive advice for solving certain oral health-related problems, even before going to the dentist. 

Oral problems are common, affecting a large segment of the population, who tends to visit the pharmacy more easily than other healthcare services including the dental office. Pharmacies are healthcare facilities that are headed by a highly-qualified professional who has been trained to give out oral health advice and promote healthy habits. Consequently, these professionals can actively promote oral hygiene habits while increasing awareness of the importance of dental care. They also must advise patients to visit their dentist or periodontist depending on the severity of their oral disease. 

The ideal environment 

Pharmacies are healthcare facilities that are easy for anyone to access and that not only provide drugs prescribed by doctors or dentists, but also are useful for receiving advice on general health issues or on oral healthcare to prevent caries, periodontal disease and other oral diseases, while promoting healthy habits for maintaining health over time. 

Therefore, pharmacists play an important role in prevention: offering advice in relation to oral hygiene (brushing frequency/duration and the most suitable instruments for each case) and the importance of regular visits to the dentist, as well as healthy dietary habits and advice for pregnant patients, diabetics, children, etc. These professionals are also highly involved in the field of oral health because of their participation in health campaigns, for pharmaceutical associations as well as for other oral health-related professional groups. 

So the pharmacies devote special interest to knowledge of and to dispensing a variety of products available for the treatment of oral conditions. In fact, pharmacists who are well trained in oral healthcare and nutrition are expected to provide the most appropriate healthcare advice on these diseases. In their role as educators, trainers and counsellors, pharmacists recommend the most suitable products for maintaining oral health, depending on each individual patient’s needs. 

It is important to identify products that are scientifically endorsed (meaning that sound scientific studies prove their efficacy and safety). 

Practical Advice 

These professionals offer a wide range of advice to their customers, although there are a number of recommendations and guidelines that are especially important, as they respond to questions and concerns that are commonly raised by the general public that comes to the pharmacy: 

• Tips and oral hygiene habits. Use a manual or electric toothbrush (brushing for at least 2 minutes) and interdental, or interproximal, tools (for daily cleaning of spaces between teeth – dental floss and interproximal brushes), toothpaste (with fluoride to prevent caries, with antiseptics to control bacterial plaque formation, with desensitising agents to reduce sensitivity) and mouthwash with antiseptic action (such as chlorhexidine, when indicated). Brush tongue with a toothbrush or with a tongue cleaner or scraper. Change toothbrush at least every 3 months. 

• Recommend dental visits at least once per year and visits to the periodontist or dentist when gingival inflammation, bleeding or discomfort exists. 

• Recommend a healthy diet. Good nutrition is not only required for good overall health; it is also essential for oral health. 

• Advice for pregnant women. Women tend to visit the pharmacy more often during pregnancy. Pharmacists can take this opportunity to provide both general and oral healthcare advice. During pregnancy, particularly if dietary habits change, the prevalence of caries may increase, and changes in gums are usual with the appearance of inflammation, bleeding, redness and even enlargement, which are all related to bacterial plaque build-up and particularly sensitive gums due to hormonal changes during pregnancy. In these cases, pharmacists should recommend the patient visit their dentist or periodontist, and more importantly, they should recommend preventive methods and habits to ensure adequate oral care during pregnancy. 

• Advice for diabetic patients. Patients suffering from diabetes are at higher risk for developing infection, including periodontitis (which is three times more common in these patients). Periodontitis can hamper sugar control in diabetics. And, treating periodontitis can improve glycaemic control. Pharmacists should ask patients about their gingival health and refer them to a periodontist or dentist if inflammation exists. 

• Tooth sensitivity. Recommend use of toothpastes and mouthwashes that are specifically aimed at reducing sensitivity. 

• Halitosis. Most of the time bad breath originates in the oral cavity (around 90%), for which a visit to the dentist or periodontist should be advised. 

• Dry mouth, or xerostomia. This commonly occurs in geriatric patients or patients taking antidepressant medications. It should be recommended in these cases to hydrate the mouth, maintain optimal oral hygiene and avoid dry mouth-producing products. 

• Avoid, as much as possible, drugs that pose a threat to gingival health. As previously mentioned, antidepressant medications and other drugs can reduce saliva production (which protects our teeth), antihypertensives and immunosupressants may cause gingival enlargement, and bisphosphonates (indicated for osteoporosis) have been associated with some oral disorders following surgical interventions.