Table 3.145.
Key considerations for dental management in Sjögren's syndrome (see text)
| Management modifications* | Comments/possible complications | |
|---|---|---|
| Risk assessment | 1 | Multi-system involvement |
| Appropriate dental care | 1 | Possibly corticosteroid supplementation |
| Pain and anxiety control | ||
| – Local anaesthesia | 0 | |
| – Conscious sedation | 1 | Multi-system involvement |
| – General anaesthesia | 3/4 | Respiratory infections |
| Patient access and positioning | ||
| – Access to dental office | 0 | |
| – Timing of treatment | 1 | See Rheumatoid arthritis |
| – Patient positioning | 1 | See Rheumatoid arthritis |
| Treatment modification | ||
| – Oral surgery | 0 | |
| – Implantology | 1 | Evaluate oral hygiene |
| – Conservative/Endodontics | 0 | |
| – Fixed prosthetics | 1 | Delay until 1 year caries free |
| – Removable prosthetics | 1 | Minimise acrylic–mucosa contact |
| – Non-surgical periodontology | 0 | |
| – Surgical periodontology | 0 | |
| Hazardous and contraindicated drugs | 1 | Trimethoprim allergy |
*
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.