Dr. Heather-Dawn Lawson-Myers engaged in an insightful conversation with guest Tom Viola, a renowned pharmacist with a 30-year history in the field and an unexpected but profound love for dentistry.

Tom Viola's Journey into Dentistry & the Art of "Edutainment"

Tom Viola's journey into the world of dentistry commenced around two decades ago when he began teaching pharmacology to dental and dental hygiene students. Soon he found himself addressing dentists and dental hygienists in lecture halls, sharing his knowledge and passion for the subject. His affinity for what he does was palpable as he echoed the adage, "When you love what you do, you never work a day in your life."

Tom Viola's teaching style is a lively blend of entertainment and education, often referred to as "edutainment". He breathes life into a subject that might otherwise be perceived as dry or tedious, captivating audiences and ensuring they remain engaged, even in the early morning sessions.

One of the compelling topics explored in this interview was the often-blurred line between what is considered a drug and a dietary supplement. Viola provided a comprehensive explanation of the definition of a drug, which isn't required for life per se, but is essential if someone has a severe condition. The U.S. FDA defines a drug as something used to diagnose, prevent, or treat a disease, whereas everything else is classified as a supplement or a vitamin.

The Blurred Line: Drugs vs. Dietary Supplements

In the vast realm of dietary supplements, herbal remedies, and other natural substances, the distinction between what is a drug and what is not can sometimes become murky. Viola further explained that some countries consider these supplements as natural remedies, while others, like the U.S., categorize them under dietary supplements.

Adding to the complexity is the fact that the FDA does not oversee dietary supplements in the U.S., which means manufacturers can bring these products to market without FDA approval or oversight. This absence of regulation can sometimes lead to subpar standardization or purity of the product, which may inadvertently cause adverse effects on consumers.

Complexities and Risks of Dietary Supplements

Despite their natural origins, dietary supplements can still have negative interactions with prescription medications. In fact, recent studies indicate that around 20% of patients combine prescription drugs with dietary supplements, a practice that could lead to an overaccumulation of effects and, consequently, potential health risks.

Viola offered valuable advice for taking patient medical histories. He emphasized the use of open-ended questions and avoidance of words like "drug" or "medication".

By asking, "What do you take?", "Why do you take it?", and "Did you take it today?", practitioners can gain a more holistic understanding of a patient's health and potential medication interactions.

Dr. Lawson-Myers and Tom Viola dug deeper into the role of dental assistants and the importance of a comprehensive understanding of a patient's medical history. Viola explained, "The dental assistant is the front door of the office... They're the ones that establish, I think, the greatest relationship with the patient in that short period of time. The level of confidence, the level of trust is all in that dental assistant."

The Role of Dental Assistants in Taking the Medical History

As such, dental assistants, with their thoughtful understanding of pharmacology, are well-equipped to gather valuable medical information from patients, thereby making the overall treatment process more efficient and effective.

Viola also expounded on the top five categories of drugs or supplements that can impact dental treatment. These are:

1. drugs affecting immunity like steroids or cannabis;
2. stimulants like ADHD medications, antidepressants, or cannabis;
3. anticoagulants and antiplatelet agents like Coumadin or Plavix and dietary supplements like garlic, ginkgo, ginger, and ginseng;
4. drugs that affect local anesthetics like methamphetamine, cocaine, and cannabis;
5. drugs causing central nervous system depression such as benzodiazepines and opioids.

The Importance of Complete and Accurate Medical Histories

His key advice to all dental offices is to take a complete and accurate medical history, and more importantly, read and understand it. He stresses,

"Never treat a stranger. Know that person well – know their medications, know the supplements, know everything about them."

He further urges dental professionals to "be the bartender." This means listening keenly to patients and speaking up when necessary, because, at times, patients may reveal vital information during casual conversations. His philosophy is all about fostering a more patient-centered approach to dentistry.

Enhancing the Patient Experience through Interpersonal Skills and Pharmacology

Tom Viola's approach is a testament to the value of interpersonal skills and comprehensive knowledge in enhancing the patient experience. As dental professionals deepen their understanding of pharmacology, they will be better equipped to provide the best care for their patients.

His philosophy of "never treat a stranger" underscores the importance of personalized dental care, which can only be achieved when there is a robust understanding of each patient's unique circumstances and medical history. Viola’s insights should serve as a beacon for dental professionals worldwide, emphasizing how nuanced patient knowledge can significantly enhance the delivery of dental care. 

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