Table 3.153.

Key considerations for dental management in transplant patients (see text)

	Management modifications*	Comments/possible complications
Risk assessment	3	Bleeding; infection; corticosteroids; viral hepatitis; pre-existing disease
Appropriate dental care	3	Postpone elective care; consider antibiotic prophylaxis; possibly corticosteroid cover
Pain and anxiety control
– Local anaesthesia	1	Chlorhexidine
– Conscious sedation	2	Avoid sedatives
– General anaesthesia	4/5	Avoid where possible
Patient access and positioning
– Access to dental office	0
– Timing of treatment	0
– Patient positioning	0
Treatment modification
– Oral surgery	2	Bleeding; infection
– Implantology	2
– Conservative/Endodontics	1
– Fixed prosthetics	1
– Removable prosthetics	0
– Non-surgical periodontology	1
– Surgical periodontology	2	Bleeding; infection
Hazardous and contraindicated drugs	2	Avoid sedatives, aspirin, acetaminophen, and drugs interfering with ciclosporin

^*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.