Table 3.18.

Key considerations in dental management in asthma (see text)

	Management modifications*	Comments/possible complications
Risk assessment	2	Asthmatic attack Prophylactic bronchodilators Consider steroid cover
Pain and anxiety control
– Local anaesthesia	1	Avoid epinephrine (sulphites)
– Conscious sedation	1	Avoid sedatives
– General anaesthesia	3–5	Pulmonary complications; cardiac failure
Patient access and positioning
– Access to dental office	0
– Timing of treatment	1	Late morning
– Patient positioning	1
Treatment modification
– Oral surgery	1/4	Consider INR
– Implantology	1/4
– Conservative/Endodontics	1
– Fixed prosthetics	1	Materials selection
– Removable prosthetics	1	Materials selection
– Non-surgical periodontology	1
– Surgical periodontology	1/4
Hazardous and contraindicated drugs	2	Avoid aspirin, NSAIDs, sulphites, penicillin, and other erythromycin drugs interacting with theophylline

^*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.