Table 3.136.
Key considerations for dental management in dental treatment in chronic renal failure (see text)
| Management modifications* | Comments/possible complications | |
|---|---|---|
| Risk assessment | 3 | Bleeding; infections; impaired drug excretion; underlying disease; hyperkalaemia |
| Appropriate health care | 3 | Consult physician; psychosocial support; haemostatic support; consider antibiotic prophylaxis |
| Pain and anxiety control | ||
| – Local anaesthesia | 1 | Bleeding tendency |
| – Conscious sedation | 1 | Preserve veins |
| – General anaesthesia | 1/4 | Anaemia; drug sensitivity |
| Patient access and positioning | ||
| – Access to dental office | 0 | |
| – Timing of treatment | 1 | The day after dialysis |
| – Patient positioning | 1 | Adjust in CAPD patients |
| Treatment modification | ||
| – Oral surgery | 3 | Delayed healing, bleeding |
| – Implantology | 3 | Avoid in some cases |
| – Conservative/Endodontics | 1 | Only single procedures |
| – Fixed prosthetics | 1 | Only single procedures |
| – Removable prosthetics | 0 | |
| – Non-surgical periodontology | 3 | Bleeding |
| – Surgical periodontology | 3 | Bleeding; tooth extraction recommended in some cases |
| Hazardous and contraindicated drugs | 3 | Many drugs are contraindicated |
CAPD, continuous ambulatory peritoneal dialysis.
*
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.