Dar-Odeh et al The rest of prescriptions were for metronidazole (11 times: 29%), ﬁrst generation cephalosporins (4 times: 10.5%), second generation cephalosporins (3 times: 7.9%), and ﬂuoroquinolone in one prescription only. NSAIDS were prescribed 27 times, while paracetamol was prescribed 14 times. Three prescriptions of opioid agents were issued by 2 dentists for three different subjects (one prescription of 10 tablets and two prescriptions of 20 tablets). The rest of prescriptions (9 in number) were for topical agents namely diclofenac sodium emulgel, chlorhexidine mouth wash and solcoseryl oral gel. Table 3 shows the types of prescribed drugs according to specialty. Procedures were classiﬁed according to their need to local anesthesia into: 1. procedures not requiring anesthesia (such as: patient examination, removal of sutures, removable pros- thetic procedures, cementation of crown and bridge work, investigations, application of ﬁssure sealant, periodontal splinting of teeth with resin composite) 2. procedures that might require anesthesia (such as: cavity preparation and endodontic treatment, scaling and implant prosthodontics) 3. procedures that deﬁnitely require anesthesia (such as: dental extraction), and 4. procedures that were not stated in the records (60 procedures). For procedures not requiring anesthesia (n = 506), one patient’s record indicated that anesthesia was used. For pro- cedures that might require anesthesia (n = 328), 11 records (3.4%) indicated the use of anesthesia. For procedures that deﬁnitely require anesthesia (n = 105), 28 patients records indicated the use of anesthesia (26.7%). The term “LA used” was found in 22 records without giving any details of the anesthetic procedure. The name and quantity of the local anesthetic were documented in 13 records. Only 5 records Table 3 Types of prescribed drugs according to specialty Amoxycillin- First Metronidazole clavulinic acid generation Cephalosporin 2 2 1 1 4 2 2 1 4 Oral surgery Endodontics Oral medicine Periodontics Conservative dentistry Pediatric dentistry Prosthodontics 1114 16 6 1 2 3 1 documented the full elements of a local anesthetic injection. It was observed that only one type of anesthetic was docu- mented which was lidocaine 2% with 1:100,000 epinephrine. All injections mentioned used minimal amounts of local anesthetic solutions ranging from 2–6 ml. Discussion This study was performed on a prospective basis. A memo- randum was distributed to all dental specialists in the depart- ment explaining the aim of the study and its prospective nature. This was to allow all concerned dentists to express their opinions and to measure their compliance with docu- menting the required information. The work on collecting the records started April 3rd and it was decided to end it on April 26th after collecting 1000 records. It was thought that this number of records was a representative sample and was still collected randomly. About 15.6% of patients had one or more medical problems. Furthermore, medical history was not mentioned at all in 13 records. It is worth mentioning that dental records constitute part of the patient’s medical ﬁle at the University of Jordan Hospital. Patients had a wide age range including the young chil- dren and the elderly. The medically compromised patients, children and elderly patients should be managed in a cautious approach. Needless to say that dental procedures are stressful to healthy as well as medically compromised patients. In the elderly the hepatic metabolism of many drugs is reduced, in some cases in the order of 30%–50% (Le Couteur et al 2004). Altered physiology leads to altered pharmacokinetics, so the most appropriate dose in an elderly person may not be the dose that is typically used in the general population (Faulkner et al 2005). Aging of the population involves many parts of the world. As the population becomes older and drug consumption subsequently increases, adverse drug Paracetamol NSAID Opioid analgesics Topical analgesics Mouth wash 12 2 1 2 3 5 1 13 1 2 1 3 4 Therapeutics and Clinical Risk Management 2008:4(5)