Table 3.5.
Key considerations for dental management in alcoholism (see text)
| Management modifications* | Comments/possible complications | |
|---|---|---|
| Risk assessment | 2 | Liver cirrhosis, consent |
| Preventive dentistry and education | 1 | Alcoholism screening, oral cancer screening and diet counselling |
| Pain and anxiety control | ||
| – Local anaesthesia | 1 | Tolerance |
| – Conscious sedation | 1 | Additive effect |
| – General anaesthesia | 5 | Resistance, aspiration |
| Patient access and positioning | ||
| – Access to dental office | 0 | |
| – Timing of treatment | 1 | Morning |
| – Patient positioning | 0 | |
| Treatment modification | ||
| – Oral surgery | 1 | Bleeding tendency |
| – Implantology | 5 | Poor risk group |
| – Conservative/Endodontics | 1 | Maintenance compromised |
| – Fixed prosthetics | 1 | Maintenance compromised |
| – Removable prosthetics | 0 | |
| – Non-surgical periodontology | 1 | Maintenance compromised |
| – Surgical periodontology | 1 | Bleeding tendency |
| Hazardous and contraindicated drugs | 2 | Sedatives, NSAIDs, metronidazole, cephalosporins |
*
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.