Table 3.143.
Key considerations for dental management in schizophrenia (see text)
| Management modifications* | Comments/possible complications | |
|---|---|---|
| Risk assessment | 2 | Phenothiazines adverse effects; extrapyramidalism; impaired gag reflex |
| Appropriate dental care | 2 | Behaviour control; consent issues |
| Pain and anxiety control | ||
| – Local anaesthesia | 1 | Drug induced epinephrine reversal or block |
| – Conscious sedation | 4 | Drug interactions; hallucinations |
| – General anaesthesia | 3/4 | Avoid barbiturates |
| Patient access and positioning | ||
| – Access to dental office | 0 | |
| – Timing of treatment | 1 | Short appointments |
| – Patient positioning | 1 | Avoid orthostatic hypotension |
| Treatment modification | ||
| – Oral surgery | 1 | |
| – Implantology | 3/5 | Usually not recommended |
| – Conservative/Endodontics | 1 | |
| – Fixed prosthetics | 1 | |
| – Removable prosthetics | 1 | Possibly not recommended |
| – Non-surgical periodontology | 1 | |
| – Surgical periodontology | 1 | |
| Hazardous and contraindicated drugs | 1 | Avoid tramadol |
*
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.