Table 3.87.

Key considerations for dental management in immunosuppressive treatment (see text)

	Management modifications*	Comments/possible complications
Risk assessment	3	Oral and extraoral infections
Appropriate dental care	3/4	Consider antimicrobial prophylaxis and steroid cover
Pain and anxiety control
– Local anaesthesia	1	Chlorhexidine rinse
– Conscious sedation	1	Respiratory function
– General anaesthesia	3/4
Patient access and positioning
– Access to dental office	0
– Timing of treatment	0
– Patient positioning	0
Treatment modification
– Oral surgery	3/4	Chlorhexidine; antibiotic cover
– Implantology	3/4
– Conservative/Endodontics	2
– Fixed prosthetics	2
– Removable prosthetics	2
– Non-surgical periodontology	3/4	Chlorhexidine; antibiotic cover
– Surgical periodontology	3/4
Hazardous and contraindicated drugs	2	Avoid drugs which may increase the immunosuppressive agents' levels/toxicity

^*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.