Table 3.15.

Key considerations in dental management in asplenia (see text)

	Management modifications*	Comments/possible complications
Risk assessment	2	Antimicrobial prophylaxis is not indicated Thrombocytopenia Chlorhexidine mouthwash before dental treatment
Pain and anxiety control
– Local anaesthesia	0
– 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	1	Possible bleeding tendency
– Implantology	1	Possible bleeding tendency
– Conservative/Endodontics	0
– Fixed prosthetics	0
– Removable prosthetics	0
– Non-surgical periodontology	1
– Surgical periodontology	1	Possible bleeding tendency
Hazardous and contraindicated drugs	1	Some patients are treated with corticosteroids

^*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.