title: The dental patient who is "high:" ethical and scientific recommendations for the standard of care.
abstract: Patients sometimes appear for dental appointments after consuming alcohol or marijuana. There is presently no consensus standard of care in this area, and dentists vary in their responses to such patients. This paper includes interviews with practitioners and a review of the relevant biochemical and physiological science. The ethics of various ways to handle this challenging situation are examined, and evidence-based recommendations for dental practice are offered. While there is reason for caution, the authors conclude that a blanket "do not treat" policy is unwarranted. Informed consent and transportation safety issues pose significant moral challenges when a dental patient is "high."
authors.affiliation: University of the Pacific, Arthur A. Dugoni School of Dentistry, San Francisco, USA. bpeltier@pacific.edu
authors.forename: Bruce
authors.initials: B
authors.lastname: Peltier
authors.forename: Lola
authors.initials: L
authors.lastname: Giusti
authors.forename: Terry
authors.initials: T
authors.lastname: Hoover
authors.forename: Jennifer
authors.initials: J
authors.lastname: Fountain
authors.forename: Jared
authors.initials: J
authors.lastname: Persinger
authors.forename: Scott
authors.initials: S
authors.lastname: Sutter
mesh_terms: D000428:Alcohol Drinking; D001334:Automobile Driving; D002186:Cannabinoids / Q000378:metabolism; D002985:Clinical Protocols; D003812:Dentist-Patient Relations; D004347:Drug Interactions; D000431:Ethanol / Q000378:metabolism; D004990:Ethics, Dental; D006801:Humans; D007258:Informed Consent; D008385:Marijuana Smoking; D053210:Pharmaceutical Preparations, Dental / Q000378:metabolism; D016079:Refusal to Treat; D055986:Vital Signs
chemical_list: D002186:Cannabinoids; D053210:Pharmaceutical Preparations, Dental; D000431:Ethanol