Table 3.23.

Key considerations in dental management in bone marrow transplantation (see text)

	Management modifications*	Comments/possible complications
Risk assessment	3	Dental screening Delay elective dental treatment 6 months; Immunosuppression; Bleeding tendency
Pain and anxiety control
– Local anaesthesia	0
– Conscious sedation	0
– General anaesthesia	3–5
Patient access and positioning
– Access to dental office	0
– Timing of treatment	2	Coordinate with GA/other oncology treatment
– Patient positioning	0
Treatment modification
– Oral surgery	3	Evaluate partially erupted teeth
– Implantology	3
– Conservative/Endodontics	2	Only simple procedures
– Fixed prosthetics	2	Only simple procedures
– Removable prosthetics	1
– Non-surgical periodontology	3
– Surgical periodontology	3
Hazardous and contraindicated drugs	2	Immunosuppressants
		Steroid cover

^*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.