Table 3.152.

Key considerations for dental management in thrombocytopenia (see text)

	Management modifications*	Comments/possible complications
Risk assessment	2	Haemorrhage; infections; long-term corticosteroids
Appropriate dental care	1–4	According to procedure and platelet count
Pain and anxiety control
– Local anaesthesia	1	Regional block
– Conscious sedation	1	Haematoma
– General anaesthesia	3/4	Airway
Patient access and positioning
– Access to dental office	0
– Timing of treatment	0
– Patient positioning	0
Treatment modification
– Oral surgery	1–4	According to procedure and platelet count
– Implantology	3
– Conservative/Endodontics	1
– Fixed prosthetics	1
– Removable prosthetics	0
– Non-surgical periodontology	1–4	According to platelet count
– Surgical periodontology	1–4	According to platelet count
Hazardous and contraindicated drugs	1	Avoid aspirin and NSAIDs, amoxicillin, ampicillin; consider steroid supplementation

^*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.