Dental Management Of Rheumatic Diseases Flashcards
(20 cards)
What are the key considerations for dental management in patients with rheumatoid arthritis (RA)?
Short dental appointments, comfortable chair positioning, frequent position changes, and consideration of physical supports. Evaluate manual dexterity and ability to perform home care.
How should dental treatment plans be modified for patients with severe joint pain or limited mobility due to RA?
Avoid long appointments, consider removable prostheses for ease of insertion/removal, and assess patient’s ability to maintain oral hygiene effectively.
What are the oral manifestations of rheumatoid arthritis that may affect dental treatment?
TMJ pain/dysfunction, decreased jaw function, crepitus, and occlusal changes due to condylar erosion.
What are common oral complications in patients taking NSAIDs for RA?
Prolonged bleeding, oral ulceration, and stomatitis, especially with drugs like ibuprofen, naproxen, and indomethacin.
What dental considerations are associated with glucocorticoid therapy in patients with SLE or RA?
Adrenal suppression, masking of oral infection, impaired healing, and increased risk of oral infections.
What are the oral manifestations of systemic lupus erythematosus (SLE)?
Painful ulcerations, erythematous lesions with white spots or radiating peripheral lines, and oral lesions resembling lichen planus or leukoplakia.
What modifications should be considered for dental treatment in patients with severe SLE and renal involvement?
Consult with the patient’s physician to assess renal function, evaluate hematologic profile (CBC, PT, PTT), and adjust medications as needed.
How is xerostomia managed in patients with Sjögren’s Syndrome?
Increase fluid intake, use sugar-free candy or gum, avoid alcohol and caffeine, apply artificial saliva, and consider medications like pilocarpine or cevimeline.
What are the primary oral complications in patients with Sjögren’s Syndrome?
Xerostomia, increased dental caries, oral candidiasis, dysgeusia, angular cheilosis, and burning tongue.
What are the contraindications for the use of pilocarpine and cevimeline in Sjögren’s patients?
Uncontrolled asthma, acute iritis, narrow-angle glaucoma, and other parasympathetic contraindications.
How does prolonged NSAID use affect dental treatment in patients with rheumatologic conditions?
Increased bleeding risk, especially with drugs like aspirin, ibuprofen, and naproxen, which interfere with platelet function.
What is the ADA guideline regarding antibiotic prophylaxis for patients with prosthetic joint implants?
Antibiotic prophylaxis is generally not recommended for preventing prosthetic joint infection during dental procedures, except in cases of immunosuppression or specific high-risk conditions.
What clinical manifestations of rheumatoid arthritis (RA) can affect TMJ function?
Pain, swelling, decreased range of motion, crepitus, and potential erosion of the condyle leading to occlusal changes.
What are the primary dental treatment modifications for patients with limited joint mobility due to osteoarthritis (OA)?
Adjust chair positioning, shorten appointments, provide physical supports, and assess for difficulties with maintaining oral hygiene.
What systemic complications of SLE may impact dental management?
Renal dysfunction, thrombocytopenia, leukopenia, and risk of adrenal suppression in patients on corticosteroids.
What are the common oral side effects of DMARDs such as methotrexate and azathioprine?
Mucositis, oral ulcerations, stomatitis, delayed healing, and increased risk of infection due to immunosuppression.
What dental management considerations are associated with systemic glucocorticoid use in patients with autoimmune diseases?
Monitor for adrenal suppression, assess risk of infection, and avoid prolonged or invasive procedures without medical consultation.
What are the dental implications of anti-TNF-alpha therapies like infliximab or etanercept?
Potential increased risk of infection and delayed healing, although no direct oral complications are typically associated.
What preventive strategies should be implemented for patients with xerostomia to minimize dental caries?
Fluoride rinses, xylitol gum, increased oral hygiene, regular dental visits, and saliva substitutes.
What specific precautions should be taken when treating a patient with Sjögren’s Syndrome undergoing dental extractions?
Assess salivary flow, implement moisture control measures, provide antimicrobial rinses, and monitor for delayed healing and secondary infections.
