Medical Management Guidelines for the Provision of Dental Care
|9191||July 3, 2012||1|
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.
Siegel M. Medical Management Guidelines for the Provision of Dental Care. MedEdPORTAL Publications; 2012. Available from: https://www.mededportal.org/adea/publication/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
- To determine the need to request consultation with the medical or dental care provider.
- 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.
- To allow for dental treatment plan modifications to accommodate the patient’s medical conditions and complexity.
- To utilize the published guidelines for antibiotic premedication of dental patients prior to invasive dental care to prevent indiscriminate of antibiotic medications.
- To apply guidelines for anticoagulation and steroid supplementation for dental procedures.
- 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).
- To recognize treatment needs for oral conditions associated with AIDS, chemotherapy and chronic systemic conditions.
- To appropriately order medical or dental laboratory testing.
- To provide appropriate informed consent to the patient.
- 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.
- To allow physicians to understand the dental sequalae of systemic disorders so they better understand a dentist’s clinical queries.
- To support a team approach to oral, overall health maintenance, and treatment needs through responsive and respectful communication between dental and medical providers.
- Guide, Referral and Consultation, Building Oral Health Capacity (BOHC) Collection, Medical Dental Interface, Oral-Systemic Health Interaction
Interpersonal & Communication Skills
Knowledge for Practice
- Clinical Exam
Professional & Faculty Development
Allied Dental Student
- Allied Dental Student
Professional School Post-Graduate Training
Authors & Co-Authors
Michael Siegel, DDS
Nova Southeastern University
Sponsorship or Funding Source
This project is sponsored in part by funding from the Health Resources and Services Administration/Maternal Child Health Bureau grant #U44MC20223.
Effectiveness and Significance
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.
Special Implementation Guidelines or Requirements
- A stand-alone document for use on a computer, smart phone, network or in hard copy to assist the medical or dental providers in direct clinical patient management.
- This guide can be incorporated or linked to an electronic patient database to allow the clinician to access this information from within the electronic patient database and incorporate pertinent recommendations into individual patient records.
- This guide can be used as a template for the development of interprofessional curriculum related to medical and dental topics. Both medical and dental educators can utilize this guide as a template for modifying their curricula.
- This guide can provide the basis for case construction for case-based learning modules.
- This guide can serve as a literature source as it lists current references associated with each topic.
- This guide can be used as a basis for interprofessional communication by utilizing the consultation forms found in the appendices.
There is significant empiricism and inconsistencies between medical and dental providers when prescribing assessing the need for the prescription of antibiotic premedication, altering anticoagulants, supplementing steroids, managing hypertension, responding to infectious diseases and management of the other disorders addressed in this guide. This guide is based on currently published guidelines and serves as a baseline on which to foster interprofessional discussion on patient specific changes to the treatment plan. This guide offers both dental and medical providers insight to their counterparts considerations and has been shown to be effective in demystifying and providing a non-confrontational basis for interprofessional communication.
This information is made available under the Creative Commons license.
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