Table 3.102.

Key considerations for dental management in liver transplantation (see text and Transplantation section)

	Management modifications*	Comments/possible complications
Risk assessment	2	Bacterial sepsis; bleeding due to anticoagulants; pre-existing disease
Appropriate dental care	2	Postpone elective care for 6 months; antibiotic prophylaxis
Pain and anxiety control
– Local anaesthesia	1
– Conscious sedation	2	Avoid sedatives
– General anaesthesia	4/5
Patient access and positioning
– Access to dental office	0
– Timing of treatment	0
– Patient positioning	0
Treatment modification
– Oral surgery	2	Bleeding; infection
– Implantology	2	Bleeding; infection
– Conservative/Endodontics	1
– Fixed prosthetics	1
– Removable prosthetics	0
– Non-surgical periodontology	2	Bleeding; infection
– Surgical periodontology	2	Bleeding; infection
Hazardous and contraindicated drugs	2	Avoid sedatives, aspirin and drugs interfering with ciclosporin

^*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.