Table 3.49.
Key considerations in dental management in eating disorders (see text)
| Management modifications* | Comments/possible complications | |
|---|---|---|
| Risk assessment | 2 | Vomiting; behaviour problems; poor compliance |
| Appropriate dental care | 2 | Eating disorder patient recognition; start elective care when the vomiting cycle has finished |
| Pain and anxiety control | ||
| – Local anaesthesia | 0 | |
| – Conscious sedation | 1 | Anaemia; hypokalaemia; arrhythmias |
| – General anaesthesia | 3/4 | Anaemia; hypokalaemia; arrhythmias |
| Patient access and positioning | ||
| – Access to dental office | 0 | |
| – Timing of treatment | 0 | |
| – Patient positioning | 0 | |
| Treatment modification | ||
| – Preventive dentistry | 1 | Bicarbonate rinsing; daily sodium fluoride gel |
| – Oral surgery | 0 | |
| – Implantology | 1/5 | Neglected oral hygiene; poor compliance |
| – Conservative/Endodontics | 1 | Monitor amalgams closely |
| – Fixed prosthetics | 1 | Select resistant materials |
| – Removable prosthetics | 0 | |
| – Non-surgical periodontology | 0 | |
| – Surgical periodontology | 0 | |
| Hazardous and contraindicated drugs | 1 | Avoid paracetamol/acetaminophen |
*
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.