Table 3.120.
Key considerations for dental management in nicotine abuse (see text)
| Management modifications* | Comments/possible complications | |
|---|---|---|
| Risk assessment | 1 | Associated disorders; resistance to sedation; hyperacute airways; delayed healing |
| Pain and anxiety control | ||
| – Local anaesthesia | 0 | |
| – Conscious sedation | 1 | Lung disease; resistance |
| – General anaesthesia | 1 | Lung disease; deep vein thrombosis; resistance to GA |
| Patient access and positioning | ||
| – Access to dental office | 0 | |
| – Timing of treatment | 0 | |
| – Patient positioning | 0 | |
| Treatment modification | ||
| – Oral surgery | 1 | Heavy smokers – poor healing |
| – Implantology | 1/5 | See oral surgery |
| – Conservative/Endodontics | 1 | |
| – Fixed prosthetics | 1/5 | Heavy smokers; staining |
| – Removable prosthetics | 1 | |
| – Non-surgical periodontology | 1 | Periodontitis |
| – Surgical periodontology | 1/5 | See oral surgery |
| Hazardous and contraindicated drugs | 1 | Avoid opioids |
*
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.