Medical Management Guidelines for the Provision of Dental Care

Publication ID Published Volume
9191 July 3, 2012 8

Abstract

The purpose of this guide is to assist health care professionals (dental medical, nursing, pharmacy and allied) in recognizing commonly occurring medical considerations that frequently arise in the provision of dental care. The intended outcome of this guide is to provide oral health and access to care for the patients entrusted to our care. This necessitates that the health care professionals work together in an effort to exchange their expertise so as to maximize the dental and medical prognosis for the patient. This guide is not intended as a definitive text on the diagnosis and management of oral and maxillofacial pathology, nor is it a treatise on internal medicine. This guide includes the most commonly encountered medical issues that arise in the routine provision of dental care. The literature cited is current at the time of publication; the user of this guide should ensure that the literature utilized in their clinical decision making is current. Both medical and dental educators can utilize this guide as a template for modifying their curricula.

The initial iteration of this guide (written by the author as a teaching tool, unpublished) has been made available to all dental students and specialty residents in the classroom and is directly accessible in our patient care electronic record (AxiUm). Users reference this guide in order to assess the patient in light of current medical guidelines that might alter the dental treatment plan. This guide is then used as the basis for the structuring of a medical consultation to the patient's primary care provider. Faculty have used this guide in ordering laboratory testing, consulting with the primary medical provider, in patient evaluation and in constructing lectures.

Citation

Siegel M. Medical management guidelines for the provision of dental care. MedEdPORTAL Publications. 2012;8:9191. http://dx.doi.org/10.15766/mep_2374-8265.9191

Contains time-sensitive information that will likely be inaccurate, obsolete, or irrelevant by June 08, 2015

Contains Information Suitable for Patient Education

Educational Objectives

  1. To determine the need to request consultation with the medical or dental care provider.
  2. To develop an understanding of the commonalities of medical and dental patient management by working collaboratively with dental and medical professionals to foster a climate of mutual respect and shard values centered on the oral healthcare needs of patients.
  3. To allow for dental treatment plan modifications to accommodate the patient’s medical conditions and complexity.
  4. To utilize the published guidelines for antibiotic premedication of dental patients prior to invasive dental care to prevent indiscriminate of antibiotic medications.
  5. To apply guidelines for anticoagulation and steroid supplementation for dental procedures.
  6. To recognize the need to alter standard prescription protocols. The user will recognize the impact of drugs and medical therapies on oral health (including candidiasis, dental caries, periodontal disease, and xerostomia).
  7. To recognize treatment needs for oral conditions associated with AIDS, chemotherapy and chronic systemic conditions.
  8. To appropriately order medical or dental laboratory testing.
  9. To provide appropriate informed consent to the patient.
  10. To allow dentists to better understand the information they need to gain from working with the medical provider to ensure the safe provision of dental care.
  11. To allow physicians to understand the dental sequalae of systemic disorders so they better understand a dentist’s clinical queries.
  12. To support a team approach to oral, overall health maintenance, and treatment needs through responsive and respectful communication between dental and medical providers.

Keywords

  • Guide, Referral and Consultation, Building Oral Health Capacity (BOHC) Collection, Medical Dental Interface, Oral-Systemic Health Interaction

References

ANTICOAGULANT THERAPY

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ANTIRESORPTIVE AGENT-INDUCED OSTEONECOSIS 

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DIABETES MELLITUS

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EPINEPHERINE

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HEPATITIS

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HIV/AIDS

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HYPERTENSION

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INFECTIVE ENDOCARDITIS

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PREGNANCY

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PROSTHETIC JOINTS

  1. Antibiotic prophylaxis for bacteremia in patients with joint replacements. Information statement of the American Academy of Orthopaedic Surgeons. Http://www.aaos.org/about/papers/advistmt/1033.asp, February, 2009.
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RENAL DISEASE

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  2. DeRossi S, Glick M: Dental considerations for the patient with renal disease receiving hemodialysis, J Am Dent Assoc 1996; 127:211-219. http://dx.doi.org/10.14219/jada.archive.1996.0171
  3. Kerr AR. Update on renal disease for the dental practitioner. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2001; 92(1):9-16. http://dx.doi.org/10.1067/moe.2001.115976
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STEROID THERAPY AND SUPPLEMANTATION

  1. Miller C.S., Little JW, Falace DA. Supplemental corticosteroids for dental patients with adrenal insufficiency. J Am Dent Assoc 2001;132(11):1570-9. http://dx.doi.org/10.14219/jada.archive.2001.0092
  2. De Rossi SS, Glick M. Lupus erythematosus: considerations for dentistry. J Am Dent Assoc 1998;129(3): 330-9. http://dx.doi.org/10.14219/jada.archive.1998.0207

TUBERCULOSIS

  1. Kohn WG, Collins AS, Cleveland, JL. Guidelines for infection control in dental health-care settings – 2003. MMWR 2003; 52(RR17): 1-68. http://dx.doi.org/10.1037/e545872006-001
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XEROSTOMIA

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  5. Porter SR, Scully C, Hegarty AM. An update of the etiology and management of xerostomia. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2004;97(1):28-46. http://dx.doi.org/10.1016/j.tripleo.2003.07.010
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