Table 3.1.
Key considerations for dental management in acromegaly (see text)
| Management modifications* | Comments/possible complications | |
|---|---|---|
| Risk assessment | 2 | Blindness, diabetes, hypertension, arrhythmias |
| Preventive dentistry and education | 1 | Carpal tunnel syndrome, enlarged tongue |
| Pain and anxiety control | ||
| – Local anaesthesia | 0 | |
| – Conscious sedation | 0 | |
| – General anaesthesia | 1/4 | Kyphosis, narrow glottis |
| Patient access and positioning | ||
| – Access to dental office | 0 | |
| – Timing of treatment | 1 | Sleep apnoea, fatigue |
| – Patient positioning | 1 | Longer dental chair |
| Treatment modification | ||
| – Oral surgery | 0 | |
| – Implantology | 0 | |
| – Conservative/Endodontics | 0 | |
| – Fixed prosthetics | 0 | |
| – Removable prosthetics | 0 | |
| – Non-surgical periodontology | 0 | |
| – Surgical periodontology | 0 | |
| Hazardous and contraindicated drugs | 0 | |
*
0 = No special considerations. 1 = Caution advised. 2 = Specialised medical advice recommended in some cases. 3 = Specialised medical advice mandatory. 4 = Only to be performed in hospital environment. 5 = Should be avoided.