Table 3.144.
Key considerations for dental management in scleroderma (see text)
| Management modifications* | Comments/possible complications | |
|---|---|---|
| Risk assessment | 1 | Visceral involvement; limited oral access |
| Pain and anxiety control | ||
| – Local anaesthesia | 0 | |
| – Conscious sedation | 3 | Visceral involvement |
| – General anaesthesia | 4/5 | Visceral involvement |
| Patient access and positioning | ||
| – Access to dental office | 0 | |
| – Timing of treatment | 0 | |
| – Patient positioning | 1 | Avoid supine position |
| Treatment modification | ||
| – Oral surgery | 1 | Access may be limited |
| – Implantology | 1 | |
| – Conservative/Endodontics | 1 | Paediatric handpieces/burs |
| – Fixed prosthetics | 1 | |
| – Removable prosthetics | 1 | Difficult oral insertion |
| – Non-surgical periodontology | 1 | |
| – Surgical periodontology | 1 | |
| Hazardous and contraindicated drugs | 1 | Renal failure |
*
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.