Table 3.84.
Key considerations for dental management in hypopituitarism (see text)
| Management modifications* | Comments/possible complications | |
|---|---|---|
| Risk assessment | 2 | Adrenal crisis; hypopituitary coma |
| Appropriate dental care | 2 | |
| Pain and anxiety control | ||
| – Local anaesthesia | 1 | |
| – Conscious sedation | 3/4 | Avoid sedatives |
| – General anaesthesia | 3/4 | Hypopituitary coma |
| Patient access and positioning | ||
| – Access to dental office | 0 | |
| – Timing of treatment | 0 | |
| – Patient positioning | 1 | Postural hypotension |
| Treatment modification | ||
| – Oral surgery | 1 | |
| – Implantology | 1 | |
| – Conservative/Endodontics | 1 | |
| – Fixed prosthetics | 1 | |
| – Removable prosthetics | 1 | |
| – Non-surgical periodontology | 1 | Frequent recall |
| – Surgical periodontology | 1 | |
| – Orthodontics | 1 | Early treatment |
| – Paediatric dentistry | 1 | Fluoride supplement |
| Hazardous and contraindicated drugs | 1 | Some patients are on 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.