Table 3.39.
Key considerations in dental management in Crohn's disease (see text)
| Management modifications* | Comments/possible complications | |
|---|---|---|
| Risk assessment | 1 | Problems associated with drug therapy and malabsorption |
| Appropriate dental care | 1 | Avoid elective dental care during acute episodes |
| Pain and anxiety control | ||
| – Local anaesthesia | 0 | |
| – Conscious sedation | 0 | |
| – General anaesthesia | 1 | Check for anaemia |
| Patient access and positioning | ||
| – Access to dental office | 0 | |
| – Timing of treatment | 1 | Morning |
| – Patient positioning | 0 | |
| Treatment modification | Delay treatment during acute episodes or if ulceration is present | |
| – Oral surgery | 1 | |
| – Implantology | 1 | |
| – Conservative/Endodontics | 1 | |
| – Fixed prosthetics | 1 | |
| – Removable prosthetics | 1 | |
| – Non-surgical periodontology | 1 | |
| – Surgical periodontology | 1 | |
| Hazardous and contraindicated drugs | 2 | Avoid NSAIDs, amoxicillin-clavulanate and clindamycin; some patients are on corticosteroids |
*
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.