- Diabetics – Many diabetics unaware they are affected, look out for unexpected periodontal problems, well and moderately controlled same risk as ‘normal’, implant survival minimally affected (short term), be aware of hypoglycemia.
- HIV – 24% unaware they are infected, look for oral signs of HIV, do not focus on absolute CD4 counts, consider co-morbidities, treat as ‘normal’ with universal precautions, risk of seroconversion from needlestick is very low.
- Chemotherapy – Treat significant infection 10 days before therapy, encourage continued oral hygiene, beware of masked oral infections, crushed ice for mucositis, frequent change of soft toothbrush.
- Bisphosphonates / Anti-resorptive medications – Oral bisphosphonates low risk, maximise oral health, IV bisphosphonates / denosumab highest risk, pre treatment dental assessment vital, evidence on implant treatment is equivocal but risk appears low with oral bisphosphonates.
- Osteoradionecrosis – Pre-radiation dental plan and stabilisation imperative, radiation risk increases through life, avoid extractions in areas >60 grey, meticulous oral care to avoid extractions.
- Anticoagulants/antiplatelets – Most treatment safe with INR < 4, new anticoagulants treat like warfarin, local measures at extraction sites, no need to stop / adjust anti-platelet treatments, avoid Ibuprofen / NSAID’s.
June 26, 2022
10 Key Points from EuroPerio10... Read more
June 11, 2021
Working as a hygienist or therapist... Read more
June 6, 2021
COVID-19 – Working as a hygienist or therapi... Read more