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Background: Clonidine, an alpha 2-adrenoceptor agonist, has been recently shown to be effective in conscious sedation because of its analgesic and sedative properties, having also proven to be active in reducing neuroendocrine responses to stressful stimuli perioperatively. The current study was designed to investigate the efficacy of 150 micrograms oral clonidine as a premedicant in dentistry., Methods: In a prospective, randomized, double-blind controlled clinical trial, 40 patients, aged 16-64 yr, undergoing conservative, or prosthetic, or dental surgery procedures, received placebo (n = 20) or 150 micrograms of oral clonidine (n = 20) 90 min before the estimated time of induction of local anesthesia. A blinded observer recorded: salivary flow, systolic and diastolic blood pressure each 30 min lasting 2-3 hours, as well as the degree of pain and sedation intra and postoperatively., Results: Clonidine produced significant salivary flow reduction (p < 0.001) and sedation (p < 0.001) as well as significant difference in postoperative pain scores (p < 0.05) compared to placebo. Xerostomia persisted postoperatively in clonidine premedicated patients as compared to those given the placebo (p < 0.01). Systolic blood pressure decreased significantly only after 120 (p < 0.01) and 150 min (p < 0.001) following clonidine pretreatment, but none of the patients were treated for hypotension. 55% of the clonidine treated patients positively evaluated the experience., Conclusions: These results suggest that a dose of 150 micrograms of clonidine, given orally 90 min preoperatively, is an effective premedication in dentistry, without causing excessive haemodynamic depression and sedation, and moreover confirm that the oral route of administration is very well accepted.

The purpose of the present review is to describe the unwanted effects of drugs or chemicals in the orofacial region. The authors take into consideration the alterations of salivation such as xerostomia and ptyalism, disturbances of sense of taste, halitosis and pain and swelling of the salivary glands. The dental surgeon who suspects that an oral alteration might be a drug reaction can play an important role in preventing the development of more severe toxic effects. All this points to the importance of the knowledge of pharmacology for dental practitioners.

To evaluate the effect of cerulein on salivary secretion in man, 25 healthy volunteers have been studied. In the morning, before breakfast, saline solution (125 ml/h) has been infused at a constant flow, for one hour. Saline solution has been followed, for other 60', by saline solution + Cerulein at doses of 0.05, 0.1, 0.2, 0.3, 0.5 microgram/Kg/h. These different doses have been administered in different days according to a randomized order. A wash out by saline solution, at same velocity as before, has been carried out after Cerulein . Samples of saliva were collected every 15'. On salivary specimens the amylase activity (U/l) has been dosed. Each dose of Cerulein induced a reduction of salivary flow. By blocking the administration of Cerulein the salivary secretion returned to basal value in about one hour. No inhibitory effect has been noted on amylase secretion using different doses of Cerulein .

Eledoisin, administered to dogs by intra-carotid route, potently stimulated salivary secretion. The effect was not due to stimulation of cholinergic, adrenergic, histaminergic or 5-hydroxytryptaminergic receptors but was direct on salivary glands.