Table 3.18.
Key considerations in dental management in asthma (see text)
| Management modifications* | Comments/possible complications | |
|---|---|---|
| Risk assessment | 2 |
|
| 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.