Oral surgery report

1. MISCELLANEOUS
MANAGEMENT OF PATIENTS WITH
SYSTEMIC DISEASES

2. MANAGEMENT OF PATIENTS WITH SYSTEMIC DISEASES
MISCELLANEOUS:
‣ EPILEPSY
‣ HIV
‣ OSTEORADIONECROSIS
‣ PREGNANCY AND LACTATION

3. EPILEPSY
MISCELLANEOUS

4. EPILEPSY
DENTAL MANAGEMENT CONSIDERATIONS:
1. MEDICAL CONSULTATION
2. POSTPONE SURGERY UNTIL SEIZURES ARE WELL CONTROLLED
3. ANTICONVULSANT PREMEDICATION
4. ADMINISTRATION OF SMALL AMOUNTS OF LOCAL ANESTHETIC
AND ALWAYS AFTER PRELIMINARY ASPIRATION
5. STRESS REDUCTION PROTOCOL
6. AVOID HYPOGLYCEMIA
7. AVOID LENGTHY APPOINTMENTS

5. EPILEPSY
IN CASE OF SEIZURES:
1. STOP THE PROCEDURE
2. PUT PATIENT IN SUPINE POSITION
3. DO NOT PUT ANYTHING ON THE PATIENT’S
MOUTH
4. STATUS EPILEPTICUS >30 MINUTES

6. HIV
MISCELLANEOUS

7. HIV
ACQUIRED IMMUNE DEFICIENCY SYNDROME (AIDS)
CONDITION:
1. GENERALIZED LYMPHADENOPATHY
2. OPPORTUNISTIC INFECTIONS
3. MALIGNANCIES
4. PROGRESSIVE PERIODONTAL DISEASE WITHOUT LOCAL
FACTOR
5. HAIRY LEUKOPLAKIA
6. XEROSTOMIA

8. HIV
DENTAL MANAGEMENT CONSIDERATIONS:
1. CONSULTATION
2. STRICT INFECTION CONTROL MEASURES
3. PROGRAMMING THE SURGICAL PROCEDURE AS
THE LAST APPOINTMENT OF THE DAY.
4. USING TWO PAIRS OF DISPOSABLE GLOVES.

9. OSTEORADIONECROSIS
MISCELLANEOUS

10. OSTEORADIONECROSIS
RADIATION THERAPY
1. THE SURGICAL PROCEDURE MUST BE CAUTIOUSLY PERFORMED,
AFTER AT LEAST A YEAR HAS PASSED WITHOUT SYMPTOMS
FOLLOWING THE LAST RADIOTHERAPY SESSION AND
2. THE PATIENT IS GIVEN LARGE DOSES OF PROPHYLACTIC
ANTIBIOTICS FOR SEVERAL DAYS.
3. WOUND CLOSURE IS OBLIGATORY
4. EXTRACTION IS PERFORMED BEFORE RADIOTHERAPY, 7–10
DAYS MUST PASS BEFORE THE WOUND HEALS AND
RADIOTHERAPY BEGINS.

11. OSTEORADIONECROSIS
MANAGEMENT CONSISTS OF COMBINED SURGICAL
AND PHARMACEUTICAL TREATMENT, WHILE THE USE
OF HYPERBARIC OXYGEN IS BENEFICIAL.

12. PREGNANCY AND LACTATION
MISCELLANEOUS

13. PREGNANCY AND LACTATION
1ST TRIMESTER
‣ BECAUSE EVERY INTERVENTION THAT MAY
CAUSE HYPOXIA MAY HAVE A HARMFUL EFFECT
ON THE EMBRYO BE RESPONSIBLE FOR
SPONTANEOUS ABORTION.

14. PREGNANCY AND LACTATION
2ND TRIMESTER
‣ THE PATIENT WITH A PROBLEM-FREE HISTORY IS
NOT AT RISK, PROVIDED THAT THE SURGICAL
PROCEDURE IS SHORT AND AS PAIN-FREE AS
POSSIBLE.

15. PREGNANCY AND LACTATION
3RD TRIMESTER
‣ AS FAR AS THE THIRD TRIMESTER IS
CONCERNED, EVERY PROCEDURE SHOULD BE
AVOIDED IN THE LAST DAYS OF PREGNANCY,
BECAUSE OF THE POSSIBILITY OF THE BABY
BEING BORN DURING THE DENTAL PROCEDURE.

16. PREGNANCY AND LACTATION
BEST TIME FOR THE DENTAL PROCEDURE IS IN THE
MIDDLE OR 2ND TRIMESTER DUE TO:
‣ MINIMAL NAUSEA AND VOMITING
‣ STABLE FETUS
‣ LOW INCIDENCE OF OBSTETRICAL
COMPLICATIONS
EMERGENCY TREATMENT CAN BE DONE AT ANY TIME

18. TEXT
DENTAL PROCEDURES INVOLVES PROVIDING
POTENTIALLY HARMFUL ELEMENTS FOR PREGNANT
FEMALE INCLUDING:
‣ RADIOGRAPHS
‣ DRUG ADMINISTRATION
‣ PAIN AND STRESS
‣ SUPINE HYPOTENSION IN LATE PREGNANCY

20. PREGNANCY AND LACTATION
DENTAL MANAGEMENT CONSIDERATIONS:
‣ CONSULT THE PATIENT’S OBSTETRICIAN
‣ SHORT APPOINTMENTS
‣ AVOID PAINFUL STIMULI
‣ AVOID PLACING THE PATIENT IN SUPINE POSITION
‣ AVOID RADIOGRAPHS
‣ IT SHOULD BE LIMITED AND USED ONLY AFTER 1ST TRIMESTER (IF
NECESSARY USE LEAD APRON)
‣ LA IS MORE SUITABLE THAN GA
‣ AVOID DRUGS WITH TERATOGENIC POTENTIAL

21. PREGNANCY AND LACTATION
DRUGS CONTRAINDICATED AND ALTERNATIVES IN
PREGNANCY:
Item To be avoided Preferable
Analgesics
Aspirin
NSAIDs
Paracetamol
Antibiotics
Tetracycline
Aminoglycosides
Streptomycin
Metronidazole
Penicillin
Others Corticosteroids

22. PREGNANCY AND LACTATION
ALL PREFERABLE MEDICATIONS HAS TO BE
APPROVED BY THE PATIENT’S GYNECOLOGIST

23. PREGNANCY AND LACTATION
MEDICATIONS TO AVOID DURING LACTATION:
‣ AMPICILLIN
‣ TETRACYCLINE
‣ ASPIRIN
‣ STEROIDS
‣ VALIUM
‣ BARBITURATES

24. PREGNANCY AND LACTATION
PERMISSIBLE DRUGS DURING LACTATION:
‣ KEFLEX
‣ ERYTHROMYCIN
‣ XYLOCAINE