1.
DENTAL
MANAGEMENT
OF THE MEDICALLY
COMPROMISED
PATIENTS
Dr Shweta_Parray_49DDCh_2017

2.
Who are Medically
Compromised Patients?

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.
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.
REGIMEN FOR HYPOGLYCAEMIA

6.
HYPERTENSIVE DISEASES

7.
ANGINA PECTORIS

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.
MYOCARDIAL INFARCTION

10.
CONGESTIVE HEART FAILURE

11.
PROPHYLACTIC ANTIBIOTIC REGIMEN
FOR CARDIAC PT.

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.
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.
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.
POST Myocardial Infarction

16.
Infective Endocarditis

17.
Diagnosis – Duke’s Criteria

18.
Complications
1.Prolonged Bleeding – Failure of Haemostasis
2.Severe Internal Bleeding – Risk of Shock
3.High risk of Postoperative Infections.

19.
•Emergency in MC Patients

20.
Thankyou

21.
RESPIRATORY DISORDERS

22.
BRONCHIAL ASTHMA

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.
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.
LIVER DISORDERS

26.
Dental management

27.
CHRONIC RENAL FAILURE

28.
THYROID GLAND DISORDER

29.
THANK YOU