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Medically Compromised Patients In Dental Clinic

Mai Mamdouh Hamed

dental management of medically compromised patients

  • Dental Management Of Medically Compromised Pediatric Patients

hemophilia patient

  • Hemophilia Patient

diabetes patient

  • diabetes patient

Organs

Transplantation

OrgansTransplantation

Hemophilia Pediatric Patient

Hemophilia Pediatric Patient

Definition

What is hemophilia?!

. Hemophilia is an inherited bleeding disorder. Children with hemophilia can’t stop bleeding because they don’t have enough clotting factor in their blood.

Symptoms

What are the symptoms of hemophilia?

. The most common symptom of this disorder is heavy, uncontrollable bleeding.

Some children patient most often have bleeding only with major surgeries or tooth extractions. These children may not even be diagnosed until bleeding complications from a surgery occur.

Severe haemophilia is Bleeding can occur in these children. even with the minimal activities of daily life.

Bleeding may also occur from no known injury. Bleeding most often occurs in the joints and in the head.

Dental Management

How is hemophilia managed?

1- Discuss the medications currently being taken with the child's dentist.

2- local anesthesia is contraindicated. Gingival trauma should be minimized during treatment. Hospitalization may be considered if invasive dental treatment is required.

Diabetes Pediatric Patient

Definition

-Diabetes mellitus is the third most common chronic disease in children and adolescent.

-Type 1 diabetes results from the autoimmune destruction of insulin-producing pancreatic b-cells, creating a deficiency of circulating insulin.

Oral Manifestation

Oral Manifestation

1- Periodontal Disease.

2- Periapical Pathology.

3-Dental Caries.

4-mucosal disorders (chronic immunosuppression, delayed healing, and/or salivary hypofunction, oral fungal infections such as oral candidiasis, fissured tongue, irritation fibroma, traumatic ulcers and lichen planus).

5-Xerostomia.

6-Taste disturbance.

7-Burning Mouth Syndrome.

Patient Management

Patient Management

1- morning appointments approximately 60 to 90 minutes after breakfast are ideal.

2-At the beginning of the appointment, a thorough health history should be obtained, including the type of diabetes, date of diagnosis, methods used to control diabetes, current medications and dosages, last visit with a physician.

3-Measuring blood glucose levels with a finger-stick glucose test.

4- No Dental Treatment in uncontrol diabetes.

organs transplantation in pediatric

Organs Transplantation

Patient Management

Patient Management

Pre-transplantation dental care guidelines:

1-Consult with patient's physician.

2-Perform a dental cleaning/prophylaxis.

3- Treat all active dental diseases.

4-Postpone elective treatment.

5-Remove all potential sources of acute or chronic infection, including partially erupted third molars.

Reinforce oral hygiene and home care instructions.

6-Initiate daily antibacterial mouth rinses.

Post-transplantation dental care guidelines (immediate post-transplantation period usually defined as 6 months post-transplant):

1- Consultation with the physician.

2- Emergency care of dental infections only Stable post-transplantation period.

3- Frequent recall and prophylaxis.

4- Daily antibacterial mouth rinses.

5- No NSAIDs.

6- Screening for oral and head and neck cancers.

7- Corticosteroid supplementation, if necessary.

-Post-transplantation rejection period (if applicable):

1-Consultation with the physician.

2-Emergency care of dental infections only

Patient Management

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