Table 3.129.

Key considerations for dental management in porphyria (see text)

	Management modifications*	Comments/possible complications
Risk assessment	1	Liver function, blood test
Pain and anxiety control
– Local anaesthesia	1	Avoid some local anaesthetics
– Conscious sedation	1	Avoid some benzodiazepines
– General anaesthesia	4	Avoid some general anaesthetics
Patient access and positioning
– Access to dental office	0
– Timing of treatment	1	Evening
– Patient positioning	0
Treatment modification
– Oral surgery	0	Avoid some drugs
– Implantology	0
– Conservative/Endodontics	1	Avoid light-cured fillings
– Fixed prosthetics	0
– Removable prosthetics	0
– Non-surgical periodontology	0
– Surgical periodontology	0
Hazardous and contraindicated drugs	2	Many drugs are contraindicated

^*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.