[Verified Answer]: Jim H. is a 65-year-old patient who is coming

Jim H. is a 65-year-old patient who is coming to the dental office for periodontal maintenance. He had a mild myocardial infarction a year ago and states on his medical history that he is taking Cardizem CD, Toprol, Hyzaar, and Plavix (an antiplatelet medication). The dental hygienist observes during the intraoral examination that his plaque is quite heavy, and although his periodontal disease had been well controlled, his gingiva is now quite inflamed. On performing the periodontal probing, an excessive bleeding response is seen that does not stop for many minutes. The dental hygienist asks him whether he is taking any other medications, and he says that he does take some “natural” supplements—garlic, ginkgo biloba, and St. John’s wort to make him feel better after his heart attack.