1. EPILEPSY 2. STROKE 3. PARKINSON’S DISEASE 4. MULTIPLE SCLEROSIS Clear the area and turn the patient to the side ( to avoid aspiration) Place the chair in supine position Possible placement of a ligated mouth prop at the beginning of the procedure. Do not attempt to use a padded tongue blade. Examine for traumatic injuries. Discontinue the treatment and arrange for patient transport. Identify risk factors like, a. Hypertension b. Congestive heart failure c. Diabetes mellitus d. TIA or previous stroke e. Increasing age ≥75 years f. Elevated blood cholesterol or lipid levels g. Coronary atherosclerosis h. Cigarette smoking

1. DENTAL
MANAGEMENT OF
NEUROLOGIC
ACHIEVED BY: Dr.Maen Dawodi

2. NEUROLOGICAL DISORDERS
1. EPILEPSY
2. STROKE
3. PARKINSON’S DISEASE
4. MULTIPLE SCLEROSIS

3. 1. EPILEPSY
Dental management
1. Clear the area and turn the patient to the side ( to avoid
aspiration)
2. Place the chair in supine position
3. Possible placement of a ligated mouth prop at the beginning of
the procedure.
4. Do not attempt to use a padded tongue blade.
5. Examine for traumatic injuries.
6. Discontinue the treatment and arrange for patient transport.

4. 2. STROKE
DENTAL MANAGEMENT
1. Identify risk factors like,
a. Hypertension
b. Congestive heart failure
c. Diabetes mellitus

5. 2. STROKE
DENTAL MANAGEMENT
d. TIA or previous stroke
e. Increasing age ≥75 years
f. Elevated blood cholesterol or lipid levels
g. Coronary atherosclerosis
h. Cigarette smoking

6. 2. STROKE
DENTAL MANAGEMENT
2- Provide only urgent dental care during first 6 months
after a stroke.
3- Determine risk for bleeding problems in patients taking
anticoagulant.
4- Schedule short, stress free, midmorning appointments
5- Use minimum amount of anesthetic containing
vasoconstrictors
6- Avoid epinephrine in retraction chord.
7- Effective oral evacuation and airway management.

7. 3. Parkinson’s Disease
DENTAL MANAGEMENT
a) Minimizing the adverse outcomes of muscle’s rigidity and
tremor
b) Avoiding drug interactions (Tolcapone limits the dose of
Ephinephrine).

8. 3. Parkinson’s Disease
DENTAL MANAGEMENT
• Patients should receive dental care during the time of day at
which their medication has maximum effect.
• To reduce the likelihood of a fall from the dental chair.
• The patient should be assisted to and from the chair.
• At the end of the appointment the chair should be inclined
slowly to allow for re-equilibration.

9. 4. MULTIPLE SCLEROSIS
DENTAL MANAGEMENT
• The patient who experience relapse are unfit for routine
dental treatment.
• In stressful surgical procedure patient may require an
increase in dose of corticosteroid.

10. Reference
• Dental Management of the Medically Compromised Patient - E-Book
• By James W. Little, Donald Falace, Craig Miller, Nelson L. Rhodus

11. Thank you