Table 3.149.

Key considerations for dental management in patients treated with systemic corticosteroids (see text)

	Management modifications*	Comments/possible complications
Risk assessment	2	Adrenal crisis; underlying diseases
Appropriate dental care	2	Steroid supplementation
Pain and anxiety control
– Local anaesthesia	0
– Conscious sedation	3	Avoid sedatives
– General anaesthesia	4
Patient access and positioning
– Access to dental office	0
– Timing of treatment	0
– Patient positioning	1	Osteoporosis
Treatment modification
– Oral surgery	2	Steroid supplementation; antimicrobials required; impaired wound healing
– Implantology	2	See oral surgery
– Conservative/Endodontics	0
– Fixed prosthetics	0
– Removable prosthetics	0
– Non-surgical periodontology	1
– Surgical periodontology	2	See oral surgery
Hazardous and contraindicated drugs	1	Avoid aspirin and NSAIDs

^*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.