Medical History
1. Diabetes related to periodontal disease
2. Hypertension
3. CV Problems Infective Endocarditits needs prior antibiotic prophylaxis before treatment
4. Epilepsy- When a removable denture is given patient during an epileptic seizure can die of asphyxiation if the denture clogs the pharynx.
5. Asthma — patient must be taught how to insert and remove denture.During asthmatic attack dentures must be removed from mouth at emergency
6. Cerebral Palsy mostly common in children Pediatric dentist must treat him with special care.
Surgical History:
1. CV Surgery pacemaker affects oral prophylaxis as peizo electric scalers must not be used.
2. CNS Surgeries Affects Neuromuscular coordination problem with complete denture power brushes to be advised
Medication
Gingival Enlargement:
1. Phenytoin Na———Gingival Enlargement
2. ACE Inhibitors————–Drug Induced Lichen Planus
3. Nifedipine Enlargement
Nutritional:
1. Vitamin C Deficiency Common in Sailors and cold western countries
Stains:
1. Tetracycline Staining
Introoral examination:
Gums:
Color,Texture,stipling,edematous or non edematous
Teeth:
ADA:
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
32 31 30 29 28 27 26 25 24 23 22 21 20 19 18 17
Indian and Western Europeans use Zsigmondy Palmer system of nomenclature for teeth
Caries:
Periodontitis
Gingivitis
Bleeding on Probing:
Provisional Diagnosis:
Investigations
Final Diagnosis
Treatment Plan:
• Careful regarding drug interactions
• Emphasis on preventive care,Manual brushing,Power brushing and Flossing.
Special Precautions:
Blood Dyscracias
Hemophilia, Purpura
Blood Transfusion to be ready and must be done with concurece with physician or hematologist.
Infections:
HIV
Status to be known
Double gloves
Instruments must be discarded after use
Separate autoclave for HIV patients
CV Problems:
• Subactute bacterial endocarditis- Antibiotic Prophylaxis
• Myocardial Infarcation- Stop Aspirin and ask to come after 5 days
• Uncontrolled Hypertension Close to 180/100 to be referred to Physician
• Anticoagulants stop the medication and operate only when prothrombin time is norml
Diabetes:
Fasting blood Sugar 126mg/dl
Post Lunch 160mg/dl
Then diabetes must be controlled only then periodontal surgeries are advised.Refer to Physician and Diabetes for control
Article to be continued next week.
