Table 3.104.

Key considerations for dental management in lupus erythematosus (see text)

	Management modifications*	Comments/possible complications
Risk assessment	2	Multi-system disease; SLE symptoms exacerbation; infective endocarditis; bleeding tendency
Appropriate dental care	2/4	Bleeding tests; antibiotic prophylaxis; avoid elective dental care during active phases of SLE
Pain and anxiety control
– Local anaesthesia	0
– Conscious sedation	1
– General anaesthesia	3/4	Pulmonary disease
Patient access and positioning
– Access to dental office	0
– Timing of treatment	0
– Patient positioning	0
Treatment modification
– Oral surgery	2	Bleeding tests; consider need for antibiotic prophylaxis
– Implantology	2	See oral surgery
– Conservative/Endodontics	1
– Fixed prosthetics	1
– Removable prosthetics	1
– Non-surgical periodontology	2	See oral surgery
– Surgical periodontology	2	See oral surgery
Hazardous and contraindicated drugs	2	Avoid tetracyclines and penicillin; some patients receive corticosteroids or immunosuppressives

^*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.