Pregnancy and The Medically Compromised

Patient Dental Care

Pregnancy and dental care Untreated tooth and periodontal disease can increase the

risk of:

Giving birth to a preterm.

Low-birth-weight baby.

Should using an antibacterial mouth rinse and chewing gums or eating mints that contain xylitol to help reduce the bacteria in their mouth that cause tooth decay.

Tooth decay is caused by bacteria that a new mother can transfer to her infant.

Medications prescribed to treat diseases can negatively affect the flow and consistency of saliva and the texture of the tongue or can cause changes in the gum.

The medically compromised patient and dental care

Neurologic Disorders1. Alzheimers DiseaseIs a brain disorder, marked by deterioration of mental

capacity. Treatment plan modifications: Pay special attention to daily care of the mouth. Patients may show signs of xerostomia caused by a

prescribed psychoactive drug. Regular oral hygiene and the use of fluoride

supplements and salivary substitutes are important in preserving dental health.

2. SeizuresAbrupt suspension of motor, sensory, behavioral, or bodily function

at any time.

Treatment plan modifications: Maintain oral hygiene. Perform surgical reduction of gingival hyperplasia. Before treatment, question patients about:

o Skipping medications or mealso Stress and fatigueo Pain

1. Congestive heart failure

The heart cannot pump enough blood to the bodys other organs.

Causes:

Narrowed arteries

High blood pressure

Heart defect

Cardiovascular Disorders

2. Hypertension (high blood pressure)

Results when the heart has to work harder as it pumps against resistance such as that provided by blocked artery.

Stress is the major factor in hypertension.

3. Angina Is a coronary disease in which a decrease in blood supply to the heart

muscle causes a sharp pain in the chest. Angina is a sign that a patient is at risk for a heart attack.Treatment plan modifications for a patient with heart disease: Avoid stressful, lengthy appointments Assess vital signs before and throughout the procedure. The dentist may use premedication and nitrous oxide to help relieve

stress. The use of supplemental oxygen throughout the procedure The use of prophylactic sublingual nitroglycerin immediately before

treatment. Seat the patient in a semisupine position.

Pulmonary Disorders Affect the lungs and are characterized by airway

obstruction. Such as allergies and bronchial Asthma.

Treatment plan modification for a patient with Asthma:

Every effort should be made to minimize stress.

Schedule short appointments.

Use sedation techniques.

The use of epinephrine and aspirin should be minimized.

Such as anemia, leukemia and hemophilia

Treatment plan modifications

These patients are susceptible to bacterial infection

Antibiotic prophylaxis may need to be prescribed for high-risk procedures.

Blood Disorders

Musculoskeletal Disorders Such as Arthritis (the joints becomes inflamed and

painful)

Treatment modifications for a patient with Arthritis:

Schedule these patients in the morning and keep appointments short.

The disease can limit the patients ability to hold and use a toothbrush.

Arthritis of the jaw joints limits the patients ability to open the mouth or chew comfortably.

Endocrine Disorders1. Hyperthyroidism Is an overactive thyroid gland. Infection, physical or

emotional stress, trauma, pain or surgery may precipitate a hyperthyroid crisis, which can be fatal.

Treatment plan modification: An accurate and current history and medical consultation

are essential. Hyperthyroid patients who are not being treated are highly

sensitive to epinephrine and other amine anesthetics.

2. Diabetes Mellitus Specific problems related to dental care for a patient with diabetes include:

Acetone breath. Dehydration of oral soft tissues due to xerostomia. Red, swollen and painful gingiva due to medication therapy Alveolar bone loss, toothache and delayed healing.

Treatment plan modifications: Minimize stress by keeping appointments short and scheduling them in the

midmorning. Use sedation techniques such as administration of nitrous oxide or oral

diazepam. Instruct patient to maintain normal dietary intake before dental

appointments; the most common cause of hypoglycemia is failure to eat. Minimize the risk for infection.

Psychiatric disorder

Treatment plan modification:

Xerostomia may result from the psychoactive drug.

Regular hygiene and the use of fluoride supplements and salivary substitutes are important for preserving dental health.

Patient cooperation may cause problems.

Hearing-impaired patients

Treatment modifications:

Stand in front of patients so that they can see your face and follow your lip movements.

Do not shout. Speak slowly and distinctly.

Keep directions simple and provide visual demonstrations.

Keep a written copy of all instructions.

THANK YOU

DR.EMAN ABED