Table 3.70.
Key considerations for dental management in hepatitis (see text)
| Management modifications* | Comments/possible complications | |
|---|---|---|
| Risk assessment | 2 | Viral hepatitis transmission; bleeding tendency; drug sensitivity |
| Appropriate dental care | 2 | During acute hepatitis only emergency dental care; standard precautions; bleeding test (PT time) |
| Pain and anxiety control | ||
| – Local anaesthesia | 1 | Avoid lidocaine |
| – Conscious sedation | 1 | Reduce benzodiazepine dosage |
| – General anaesthesia | 3/4 | Avoid halothane |
| Patient access and positioning | ||
| – Access to dental office | 0 | Standard cross-infection control procedures |
| – Timing of treatment | 0 | |
| – Patient positioning | 0 | |
| Treatment modification | ||
| – Oral surgery | 2 | Prolonged bleeding |
| – Implantology | 2 | Prolonged bleeding |
| – Conservative/Endodontics | 1 | Standard cross-infection control procedures |
| – Fixed prosthetics | 1 | |
| – Removable prosthetics | 1 | |
| – Non-surgical periodontology | 2 | Prolonged bleeding |
| – Surgical periodontology | 2 | Prolonged bleeding |
| Hazardous and contraindicated drugs | 2 | Avoid acetaminophen, erythromycin estolate and tetracycline; some patients are on corticosteroids or immunosuppressives |
*
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.