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.