24 Questions
Which of the following patients might require special consideration during dental treatment?
All of the above
What is the definition of diabetes mellitus?
A chronic hyperglycaemia long enough to cause microvascular complications
What type of diabetes is also known as insulin-dependent diabetes?
Type 1 diabetes
Why might diabetic patients require special dental management?
All of the above
What is the importance of a thorough medical history in dental treatment?
To identify patients with any medical condition that may affect dental treatment
Why might oral hypoglycaemics be avoided during dental treatment?
Because they may cause hypoglycaemia during dental treatment
What is the golden rule for dental treatment of medically compromised patients?
No contraindication for any dental procedure if the patient is controlled
Why might premedication be given to patients preoperatively?
Except for anticoagulants and oral hypoglycaemics
What is the target blood glucose level for a diabetic patient?
120-180 mg/dl
What type of oral hypoglycaemic is pioglitazone?
Glitazones
What is the main hazard for a diabetic patient undergoing surgery?
Hypoglycaemia
Why should a diabetic patient inform the staff during surgery?
In case of hypoglycaemia attack
What is a consideration for dental treatment in diabetic patients?
Avoiding aspirin and steroids
What is a type of oral hypoglycaemic that includes chlorpropamide and glibenclamide?
Sulfonylureas
What is a consideration for minor surgical procedures in diabetic patients?
No special precautions are necessary apart from taking the meal
What is important in preventing hypoglycaemia during surgery?
Operation early in the morning
What is the primary goal of dental management for medically compromised patients?
To promote oral health and overall health
What should be considered when assessing a medically compromised patient?
The patient's general condition and specific drug sensitivity
What is a key aspect of managing diabetic patients in a dental setting?
Preventing hypoglycaemia
What is an important consideration when delivering dental care to diabetic patients?
The patient's oral health and overall health
Why is it important for dentists to understand drugs commonly taken for medical conditions?
To prevent drug interactions and adverse effects
What should dentists be able to do in case of a medical emergency?
Provide basic and immediate life support
What is a key aspect of planning dental care for medically compromised patients?
Assessing medical risk
What should dentists recognize in medically compromised patients?
Common medical conditions and their effects on oral health
Study Notes
Medically Compromised Patients
- Include patients with endocrine diseases, cardiovascular diseases, respiratory diseases, gastrointestinal diseases, liver diseases, renal diseases, blood diseases, neurogenic diseases, musculoskeletal diseases, and sexually transmitted diseases.
- Also include patients under corticosteroid, chemotherapeutic, or immunosuppressive drugs.
Medical History
- A: Anemia
- B: Bleeding disorders
- C: Cardiorespiratory disorders
- D: Drug treatment and allergies
- E: Endocrine disorders
- F: Fits or Faints
- G: Gastrointestinal disorders
- H: Hospital admissions and attendances
- I: Infections
- J: Jaundice and liver disorders
- K: Kidney disorders
- L: Likelihood of Pregnancy
- M: Mental state
Golden Rule
- No contraindication for any dental procedure if the patient is controlled.
- Give premedication to the patient preoperatively, except for anticoagulants and oral hypoglycemic.
Diabetic Patients
- Definition: Chronic hyperglycaemia that causes microvascular complications.
- Types of diabetes mellitus:
- Type 1: Insulin-dependent
- Type 2: Non-insulin dependent
- Type 3: Gestational
- Clinical features:
- Hyperglycaemia
- Microvascular complications
- Diagnosis:
- Glycated Hb more than 6.1% is indicative for regimen
- Complications:
- Hypoglycaemia
- Oral hypoglycaemics: sulfonylureas, biguanides, glitazones, and intestinal alpha-glusidase inhibitors
- General and dental management:
- Depends on glycemic status and type of anaesthesia
- Operation early morning, breakfast, and medication
- Conscious sedation is usually safe
- LA is safe
- Orthostatic hypotension
- Aspirin and steroids should be avoided
- Control of orofacial infection
- Routine dental treatment or short minor surgical procedures under LA can be carried out with no special precautions apart from taking the meal
- Desired blood glucose is 120-180 mg/dl (3-5mmol/l)
This quiz covers the pre and post operative consultation of patients with various medical conditions, including endocrine, cardiovascular, respiratory, and other diseases.
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