Table 3.113.

Key considerations for dental management in motor neurone disease (see text)

	Management modifications*	Comments/possible complications
Risk assessment	2	Difficult management due to head and neck paralysis; aspiration
Appropriate dental care	2/4	Short appointments; mouth props; rubber dam
Pain and anxiety control
– Local anaesthesia	0
– Conscious sedation	3	Breathing difficulty
– General anaesthesia	3/4	Breathing difficulty
Patient access and positioning
– Access to dental office	1	Physical assistance required
– Timing of treatment	0
– Patient positioning	1	Some are chairbound; otherwise place at 45 degrees
Treatment modification
– Oral surgery	1
– Implantology	1/5
– Conservative/Endodontics	1/5
– Fixed prosthetics	1/5
– Removable prosthetics	1/5	Unstable prostheses
– Non-surgical periodontology	1
– Surgical periodontology	1/5
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.