Clinical decision-support only. For use by licensed dental professionals. Not a substitute for professional judgment or a complete drug reference. Always verify with primary sources.
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Medication

Nitroglycerin

Nitrate (antianginal vasodilator)

Brand names: Nitrostat, Nitro-Dur

Oral health effects

  • Sublingual burning; emergency angina use

    Sublingual tablets/spray can cause a local tingling/burning. Should be available in the office for patients with angina.

    Clinical management: Keep the patient's nitroglycerin accessible during care; do NOT combine with PDE5 inhibitors.

  • Dizziness on standing (orthostatic hypotension)

    Vertigo, dizziness, weakness, palpitation and other signs of postural hypotension can develop, particularly when the patient is upright and immobile; this matters when sublingual nitroglycerin is given in the chair for angina.

    Clinical management: Raise the chair back slowly at the end of the appointment, let the patient sit upright for 1–2 minutes before standing, and steady them as they get up. Take extra care in older patients, after long supine procedures and when other blood-pressure-lowering drugs are taken.

Sources

  1. Adverse drug events in the oral cavity. Yuan A, Woo SB. Oral surgery, oral medicine, oral pathology and oral radiology, 2015.
  2. Nitroglycerin prescribing information (FDA label) Mylan Pharmaceuticals Inc. / DailyMed, 2024.