Table 3.11.
Key considerations for dental management in ankylosing spondylitis (see text)
Management modifications* | Comments/possible complications | |
---|---|---|
Risk assessment | 2 | Aortic valve disease; bone marrow depression |
Pain and anxiety control | ||
– Local anaesthesia | 1 | |
– Conscious sedation | 1 | |
– General anaesthesia | 3–5 | Limited mouth opening; restricted chest expansion; cardiac disease |
Patient access and positioning | ||
– Access to dental office | 0 | |
– Timing of treatment | 0 | |
– Patient positioning | 1 | Neck may be fixed in flexion |
Treatment modification | ||
– Oral surgery | 1 | |
– Implantology | 1 | |
– Conservative/Endodontics | 0 | |
– Fixed prosthetics | 0 | |
– Removable prosthetics | 0 | |
– Non-surgical periodontology | 1 | |
– Surgical periodontology | 1 | |
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.