Table 3.75.
Key considerations for dental management in Huntington's chorea (see text)
| Management modifications* | Comments/possible complications | |
|---|---|---|
| Risk assessment | 2 | Injuries with sharp instruments |
| Appropriate dental care | 2–4 | Early oral rehabilitation; communication difficulties; consent issues in advanced disease |
| Pain and anxiety control | ||
| – Local anaesthesia | 1 | |
| – Conscious sedation | 1/3/4 | |
| – General anaesthesia | 3/4 | Exaggerated responses to sodium thiopentone and succinylcholine |
| Patient access and positioning | ||
| – Access to dental office | 1 | Possibly wheelchair |
| – Timing of treatment | 0 | |
| – Patient positioning | 1 | Possibly wheelchair or bed-ridden |
| Treatment modification | ||
| – Oral surgery | 1/4 | |
| – Implantology | 5 | |
| – Conservative/Endodontics | 4/5 | |
| – Fixed prosthetics | 4/5 | |
| – Removable prosthetics | 1/5 | |
| – Non-surgical periodontology | 1/4/5 | |
| – Surgical periodontology | 1/4/5 | |
| Hazardous and contraindicated drugs | 0 | |
*
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.