Table 3.119.
Key considerations for dental management in neutropenia (see text)
| Management modifications* | Comments/possible complications | |
|---|---|---|
| Risk assessment | 2 | Infection; bleeding tendency |
| Appropriate dental care | 2/4 | Antibiotic cover; full blood picture; bleeding tests |
| Pain and anxiety control | ||
| – Local anaesthesia | 1 | Chlorhexidine rinse |
| – Conscious sedation | 2 | Consider underlying disease |
| – General anaesthesia | 2 | Consider underlying disease |
| Patient access and positioning | ||
| – Access to dental office | 0 | |
| – Timing of treatment | 2 | Avoid 2–7 days after G-CSF intake |
| – Patient positioning | 0 | |
| Treatment modification | ||
| – Oral surgery | 2 | Chlorhexidine; antibiotic cover; primary closure of surgical wound; possibly G-CSF |
| – Implantology | 2 | See oral surgery |
| – Conservative/Endodontics | 1 | |
| – Fixed prosthetics | 1 | |
| – Removable prosthetics | 1 | |
| – Non-surgical periodontology | 2 | See oral surgery |
| – Surgical periodontology | 2 | See oral surgery |
| Hazardous and contraindicated drugs | 0 | Some patients are on corticosteroids |
*
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.