Medically compromise Flashcards
(8 cards)
What is dosage of antibiotic prophylaxis
2g Amox, 1hr before procedure
What are the indications for Ab prophy + evidence
American Heart Association Infective Endocarditis, 2021
- Cardiac valve replacement/ prosthetic valve
- Heart transplant
- Prev. history of recurrent IE
- Congential heart disease
Ortho procedures requiring Ab prophy
- Seps
- Bands
- Imp
- Surgical exposure
Mx of patient at risk of IE
- Use clear aligners instead to prevent soft tissue irritation
- self ligating brackets
- bond instead of band
- Good OH
- avoid TAD, exo, bonding with close eruption if possible
Mx of epilepsy patients
Anti-epilectic drugs should be taken regularly
Avoid triggers e.g flashing dental light
No URA if poorly controlled
Low profile bracket to avoid gingival irritation
Contact dr re. recurrent gingival hyperplasia from meds
Avoid bonded retainer
VFR contoured around gingival margins
Signs and symptoms of nickel allergy
- Gingivitis in the absence of plaque
- Gingival hyperplasia
- Burning sensation in the mouth
- Metallic taste
- Numbness/tingling sensation
- Soreness of the side of the tongue
- Labial swelling
- Angular cheilitis
Extra-oral signs and symptoms can include localised dermatitis in sites of prolonged skin contact with nickel-containing objects, for example, headgear studs. This can present as a maculopapular skin rash or vasculitis-like skin lesions.
Mx of diabetic tx
- NO tx for uncontrolled diabetic
- morning appt
- regular perio review
- strict OH
- light forces: weakening of PDL and bone regeneration; Diabetic related peripheral microangiopathy can affect the peripheral vascular supply, resulting in unexplained toothache, tenderness to percussion and even loss of vitality.
- dental team able to deal with diabetic emergency
Mx of osteoporosis patients
Hx of IV bisphosphonates: NO tx.
Hx of Low dose, oral bisphophonates:
- consult GP
- warn Pt of ONJ
- non exo tx plan
- short tx/ limited tx
- treatment discontinued if teeth respond poorly to orthodontic force application.
Signs of poor response to orthodontic force:
- slow or no movement of teeth
- excessive mobility
- radiographic evidence of sclerosis around teeth or other abnormal radiographic PDL changes
