Table 3.110.

Key considerations for dental management in mania (see text)

	Management modifications*	Comments/possible complications
Risk assessment	2/3	Inappropriate behaviour
Appropriate dental care	2–4
Pain and anxiety control
– Local anaesthesia	1
– Conscious sedation	2	Avoid diazepam
– General anaesthesia	3/4	Avoid muscle relaxants; arrhythmias
Patient access and positioning
– Access to dental office	1
– Timing of treatment	1
– Patient positioning	1
Treatment modification
– Oral surgery	2
– Implantology	2
– Conservative/Endodontics	2
– Fixed prosthetics	2
– Removable prosthetics	2
– Non-surgical periodontology	2
– Surgical periodontology	2
Imaging	1
Hazardous and contraindicated drugs	2	Avoid NSAIDs, metronidazole and tetracyclines

^*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.