Table 3.78.

Key considerations for dental management in hyperparathyroidism (see text)

	Management modifications*	Comments/possible complications
Risk assessment	2	Hypertension; arrhythmias; renal disease; bone fragility
Pain and anxiety control
– Local anaesthesia	1
– Conscious sedation	1
– General anaesthesia	3/4	Avoid muscle relaxants
Patient access and positioning
– Access to dental office	0
– Timing of treatment	0
– Patient positioning	0
Treatment modification
– Oral surgery	2	Brown tumours; bone fractures
– Implantology	2
– Conservative/Endodontics	1
– Fixed prosthetics	1
– Removable prosthetics	1
– Non-surgical periodontology	1
– Surgical periodontology	1
Imaging	1	Ground-glass appearance; loss of cortical bone and lamina dura; brown tumours
Hazardous and contraindicated drugs	2	Select drugs carefully in patients with renal disease

^*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.