Pre and Post Operative Consultation of Medically Compromised Patients

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Questions and Answers

Which of the following patients might require special consideration during dental treatment?

Pregnant women

Patients with endocrine diseases

Patients with respiratory diseases

All of the above (correct)

What is the definition of diabetes mellitus?

A chronic hypoglycaemia long enough to cause macrovascular complications

A chronic hyperglycaemia long enough to cause macrovascular complications

A chronic hypoglycaemia long enough to cause microvascular complications

A chronic hyperglycaemia long enough to cause microvascular complications (correct)

What type of diabetes is also known as insulin-dependent diabetes?

Type 3 gestational diabetes

Type 2 diabetes

Type 4 non-insulin dependent diabetes

Type 1 diabetes (correct)

Why might diabetic patients require special dental management?

All of the above Signup and view all the answers

What is the importance of a thorough medical history in dental treatment?

To identify patients with any medical condition that may affect dental treatment Signup and view all the answers

Why might oral hypoglycaemics be avoided during dental treatment?

Because they may cause hypoglycaemia during dental treatment Signup and view all the answers

What is the golden rule for dental treatment of medically compromised patients?

No contraindication for any dental procedure if the patient is controlled Signup and view all the answers

Why might premedication be given to patients preoperatively?

Except for anticoagulants and oral hypoglycaemics Signup and view all the answers

What is the target blood glucose level for a diabetic patient?

120-180 mg/dl Signup and view all the answers

What type of oral hypoglycaemic is pioglitazone?

Glitazones Signup and view all the answers

What is the main hazard for a diabetic patient undergoing surgery?

Hypoglycaemia Signup and view all the answers

Why should a diabetic patient inform the staff during surgery?

In case of hypoglycaemia attack Signup and view all the answers

What is a consideration for dental treatment in diabetic patients?

Avoiding aspirin and steroids Signup and view all the answers

What is a type of oral hypoglycaemic that includes chlorpropamide and glibenclamide?

Sulfonylureas Signup and view all the answers

What is a consideration for minor surgical procedures in diabetic patients?

No special precautions are necessary apart from taking the meal Signup and view all the answers

What is important in preventing hypoglycaemia during surgery?

Operation early in the morning Signup and view all the answers

What is the primary goal of dental management for medically compromised patients?

To promote oral health and overall health Signup and view all the answers

What should be considered when assessing a medically compromised patient?

The patient's general condition and specific drug sensitivity Signup and view all the answers

What is a key aspect of managing diabetic patients in a dental setting?

Preventing hypoglycaemia Signup and view all the answers

What is an important consideration when delivering dental care to diabetic patients?

The patient's oral health and overall health Signup and view all the answers

Why is it important for dentists to understand drugs commonly taken for medical conditions?

To prevent drug interactions and adverse effects Signup and view all the answers

What should dentists be able to do in case of a medical emergency?

Provide basic and immediate life support Signup and view all the answers

What is a key aspect of planning dental care for medically compromised patients?

Assessing medical risk Signup and view all the answers

What should dentists recognize in medically compromised patients?

Common medical conditions and their effects on oral health Signup and view all the answers

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)

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Description

This quiz covers the pre and post operative consultation of patients with various medical conditions, including endocrine, cardiovascular, respiratory, and other diseases.