Table 3.52.

Key considerations for dental management in end of life care (see text)

	Management modifications*	Comments/possible complications
Risk assessment	3/4	Related to the systemic condition; aspiration pneumonia
Appropriate dental care	3–5	Individualised oral health care plan
Pain and anxiety control
– Local anaesthesia	2
– Conscious sedation	3–5
– General anaesthesia	3–5
Patient access and positioning
– Access to dental office	2/4	Possibly domiciliary care
– Timing of treatment	1
– Patient positioning	1
Treatment modification
– Oral surgery	3/4	Only simple procedures at home
– Implantology	5
– Conservative/Endodontics	5
– Fixed prosthetics	5
– Removable prosthetics	1/5	Individualised evaluation
– Non-surgical periodontology	3–5	Individualised evaluation
– Surgical periodontology	5
Hazardous and contraindicated drugs	2	Antibiotic selection; some patients receive anticoagulants or 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.