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Dental Management of a Medically Compromised Patients

Dental Management of a Medically Compromised Patients

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Dental Management of a Medically Compromised Patients - Presented by Dr. Shweta and Parray as a part of Dhaka Dental COllege OMS Department Weekly Presentation Program

Dental Management of a Medically Compromised Patients - Presented by Dr. Shweta and Parray as a part of Dhaka Dental COllege OMS Department Weekly Presentation Program

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Dental Management of a Medically Compromised Patients

  1. 1. DENTAL MANAGEMENT OF THE MEDICALLY COMPROMISED PATIENTS Dr Shweta_Parray_49DDCh_2017
  2. 2. Who are Medically Compromised Patients?
  3. 3. Dental management: 1.Defer surgery until the diabetes is well controlled; consult the patient’s physician. 2. Schedule an early morning appointment; avoid lengthy appointments. 3. Use an anxiety-reduction protocol, but avoid deep sedation techniques in outpatients.
  4. 4. Dental management: 4. Monitor pulse, respiration, and blood pressure before, during, and after surgery. 5. Maintain verbal contact with the patient during surgery. 6. Have the patient eat a normal breakfast before surgery and take the usual dose of insulin/hypoglycemic agent
  5. 5. REGIMEN FOR HYPOGLYCAEMIA
  6. 6. HYPERTENSIVE DISEASES
  7. 7. ANGINA PECTORIS
  8. 8. DENTAL MANAGENT OF ANGINA: 1.Medical consultation 2. Reduction of stress & anxiety CLONEZAPAM 1 MG (0+0+1) 10 Days 3. Local anesthesia 4. General anesthesia 5. Treatment procedures MINIMAL INVASIVE 6. Drugs used in treatment SUBLINGUAL TRINITRATES
  9. 9. MYOCARDIAL INFARCTION
  10. 10. CONGESTIVE HEART FAILURE
  11. 11. PROPHYLACTIC ANTIBIOTIC REGIMEN FOR CARDIAC PT.
  12. 12. IF PATIENT IS ALLERGIC: Adult --------- Clindamycin 600 mg OR Azithromycin 500 mg OR Cephazolin 1 gm (1 hour before Orally) ( ½ ,,, ,,,, injection) Child --------- Clindamycin 20 mg per Kg. Azithromycin 15 mg per Kg.
  13. 13. 2. Under G.A a)Adults----- 1gm Amoxicillin I.V at induction. OR 3gm Amoxicillin orally 4 hours before induction followed by 3gm Amoxicillin immediately after recovery. OR 300mg Clindamycin I.M ½ hour before induction. OR 300mg Clindamycin I/V at induction
  14. 14. b) Children ------ (5–10 years)1/2 adult (< 5 years) 1/4 adult Use an anxiety-reduction protocol. 5. Have nitroglycerin available; use it prophylactically if the physician advises. 6. Administer supplemental oxygen (optional). 7. Provide profound local anesthesia.
  15. 15. POST Myocardial Infarction
  16. 16. Infective Endocarditis
  17. 17. Diagnosis – Duke’s Criteria
  18. 18. Complications 1.Prolonged Bleeding – Failure of Haemostasis 2.Severe Internal Bleeding – Risk of Shock 3.High risk of Postoperative Infections.
  19. 19. •Emergency in MC Patients
  20. 20. Thankyou
  21. 21. RESPIRATORY DISORDERS
  22. 22. BRONCHIAL ASTHMA
  23. 23. Dental management 1. Medical consultation. • Emotional stress factors can precipitate an attack, nitrous oxide sedation is suggested • Morphine is contraindicated • Bronchodilator inhaler should be available
  24. 24. Dental management 1. Defer dental treatment until the asthma is well controlled and the patient has no signs of a respiratory tract infection. 2. Use an anxiety-reduction protocol, including nitrous oxide, but avoid the use of respiratory depressants. 3. If the patient is or has been chronically taking corticosteroids, provide prophylaxis for adrenal insufficiency. 4. Keep a bronchodilator-containing inhaler easily accessible. 5. Avoid the use of nonsteroidal anti-inflammatory drugs (NSAIDs) in susceptible patients.
  25. 25. LIVER DISORDERS
  26. 26. Dental management
  27. 27. CHRONIC RENAL FAILURE
  28. 28. THYROID GLAND DISORDER
  29. 29. THANK YOU

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