Table 3.48.
Key considerations in dental management in drug allergies (see text)
| Management modifications* | Comments/possible complications | |
|---|---|---|
| Risk assessment | 2 | Reaction types I or IV |
| Appropriate dental care | 2 | Medical history; allergist consultation |
| Pain and anxiety control | ||
| – Local anaesthesia | 2 | Amides without epinephrine are recommended |
| – Conscious sedation | 2 | |
| – General anaesthesia | 3/4 | |
| Patient access and positioning | ||
| – Access to dental office | 0 | |
| – Timing of treatment | 0 | |
| – Patient positioning | 0 | |
| Treatment modification | ||
| – Oral surgery | 1 | |
| – Implantology | 1 | |
| – Conservative/Endodontics | 1 | |
| – Fixed prosthetics | 1 | |
| – Removable prosthetics | 1 | |
| – Non-surgical periodontology | 1 | |
| – Surgical periodontology | 1 | |
| Imaging | 2 | Avoid radiological contrast medium |
| Hazardous and contraindicated drugs | 2 | Avoid aspirins (other NSAIDs) and penicillin; some patients are on corticosteroids and/or antihistamines |
*
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.