Table 3.137.
Key considerations for dental management in renal transplantation (see text)
| Management modifications* | Comments/possible complications | |
|---|---|---|
| Risk assessment | 2 | Bleeding, infections, impaired drug excretion, hypertension |
| Appropriate dental care | 1 | Pre-transplant assessment; consider need for antibiotic prophylaxis ± steroid cover; postpone elective dental care for 6 months post transplantation |
| Pain and anxiety control | ||
| – Local anaesthesia | 1 | Chlorhexidine rinse |
| – Conscious sedation | 0 | |
| – General anaesthesia | 3/4 | |
| Patient access and positioning | ||
| – Access to dental office | 0 | |
| – Timing of treatment | 0 | |
| – Patient positioning | 0 | |
| Treatment modification | ||
| – Oral surgery | 2 | Antibiotic prophylaxis; steroid cover; delayed healing, bleeding |
| – Implantology | 2 | Postpone 6 months |
| – Conservative/Endodontics | 1 | Postpone complex procedures |
| – Fixed prosthetics | 1 | Postpone complex procedures |
| – Removable prosthetics | 0 | |
| – Non-surgical periodontology | 2 | Bleeding |
| – Surgical periodontology | 2 | Delayed healing, bleeding |
| Hazardous and contraindicated drugs | 2 | Some 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.