A PROSPECTIVE STUDY OF DENTAL DISEASE PATTERN AND DRUG UTILIZATION AT THE DENTAL DEPARTMENT OF A TERTIARY CARE TEACHING HOSPITAL IN EASTERN NEPAL

Abstract

To find out the pattern of dental diseases and drug utilization at dental out patient department (OPD) of B.P. Koirala Institute of Health Sciences (BPKIHS), a tertiary care hospital. A prospective prescription audit was conducted for a period of 10 days in the dental OPD and the data was analyzed using WHO drug indicators. The total number of prescriptions analyzed were 279. Dental caries (37%), Periodontitis (14%) and chronic gingivitis (11%) were the most common diseases with a maximum incidence between the age groups of 9 to 40 years. Mean number of drugs per prescription was 2.79. Of the total prescriptions, 223 (79.9%) had 314 antimicrobial agents (AMA) constituting 40.3% of total drugs prescribed. The mean number of antimicrobial agents per prescription was 1.13. The most commonly prescribed antimicrobial agents was amoxycillin (33.1%) followed by metronidazole (24.9%), doxycycline (17.2%) and tinidazole (12.7%). Fixed dose drug combination of amoxycillin + cloxacillin (26) and ampicillin + cloxacillin (10) were prescribed in 36 of the prescriptions. Povidone iodine gargle (41.2%) was the most commonly prescribed oropharyngeal preparation followed by Chlorhexidine gluconate mouthwash (32.4%). Non- steroidal anti-inflammatory agents (20.66%), multi-vitamins (19.51%) and oropharyngeal preparations (17.45%) constituted the rest of the drugs prescribed. Diclofenac (60.86%) was the most commonly prescribed among NSAIDs and fixed dose drug combination of ibuprofen and paracetamol was prescribed in 19 of the prescriptions. All drugs were given by oral route (except for gentamicin in one prescription) and were prescribed under brand names. None of the prescriptions had instructions whether the drug should be taken before or after food. The results indicate that dental caries was the most common dental disease, anti-microbial agents were prescribed to majority of the patients and constituted a little less than half of the total drugs prescribed. Commonly used anti-microbial agent was amoxycillin which in two thirds of the cases was prescribed as an fixed dose drug combination. The high incidence of anti-microbial agent prescribing may be modified by a feedback to the prescribers. Key words: Dental morbidity, prescribing pattern, drug utilization, dental OPD, antimicrobial agents.