Table 3.117.
Key considerations for dental management in muscular dystrophies (see text)
| Management modifications* | Comments/possible complications | |
|---|---|---|
| Risk assessment | 2 | Cardiac and respiratory complications |
| Appropriate dental care | 2/4 | Disease stage and prognosis |
| Pain and anxiety control | ||
| – Local anaesthesia | 0 | |
| – Conscious sedation | 2 | Avoid benzodiazepines and opioids |
| – General anaesthesia | 3–5 | Difficult endotracheal intubation; avoid volatile anaesthetics; aspiration; malignant hyperthermia |
| Patient access and positioning | ||
| – Access to dental office | 1 | Physical assistance required |
| – Timing of treatment | 0 | |
| – Patient positioning | 1 | Orthopaedic devices; some are chairbound; otherwise position at 45 degrees |
| Treatment modification | ||
| – Oral surgery | 1 | |
| – Implantology | 1 | |
| – Conservative/Endodontics | 1 | |
| – Fixed prosthetics | 1 | |
| – Removable prosthetics | 1 | |
| – 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.