Dentist's Guide to Medical Conditions and Complications

Kanchan Ganda is the Director of Medicine at Tufts Dental School and is responsible for the creation, implementation and co-ordination of teaching dental students. Additionally, she acts as Medical Consultant for all medically complex patients seen in the Tufts Dental Clinics. She also oversees the prevention and care of medical emergencies and personally lectures in continuing education courses to faculty and outside practitioners.

Acknowledgments xii Introduction: Integration of Medicine in Dentistry xiii Section I: Patient Assessment 3 1. Routine History-Taking and Physical Examination 5 2. History and Physical Assessment of the Medically Compromised Dental Patient (MCP) 25 Section II: Pharmacology 31 3. Prescription Writing, DEA Schedules, and FDA Pregnancy Drug Categories 33 4. Local Anesthetics Commonly Used in Dentistry: Assessment, Analysis and Associated Dental Management Guidelines 40 5. Analgesics Commonly Used in Dentistry: Assessment, Analysis, and Associated Dental Management Guidelines 48 6. Odontogenic Infections and Antibiotics Commonly Used in Dentistry: Assessment, Analysis, and Associated Dental Management Guidelines 63 7. Antifungals Commonly Used in Dentistry: Assessment, Analysis, and Associated Dental Management Guidelines 83 8. Antivirals Commonly Used in Dentistry: Assessment, Analysis, and Associated Dental Management Guidelines 87 Section III: Acute Care and Stress Management 91 9. Management of Medical Emergencies in the Dental Setting: Assessment, Analysis, and Associated Dental Management Guidelines 93 10. Oral and Parenteral Conscious Sedation for Dentistry: Assessment, Analysis, and Associated Dental Management Guidelines 110 Section IV: Hematopoietic System 125 11. Complete Blood Count (CBC): Assessment, Analysis, and Dental Management Guidelines 127 12. Red Blood Cells (RBCs) Associated Disorder: Anemia: Assessment, Analysis, and Associated Dental Management Guidelines 134 13. Red Blood Cells Associated Disorder: Polycythemia: Assessment, Analysis, and Associated Dental Management Guidelines 144 14. Red Blood Cells Associated Disorder: Hemochromatosis: Assessment, Analysis, and Associated Dental Management Guidelines 146 Section V: Hemostasis and Associated Bleeding Disorders 149 15. Primary and Secondary Hemostasis: Normal Mechanism, Disease States, and Coagulation Tests: Assessment, Analysis, and Associated Dental Management Guidelines 151 16. Platelet Disorders: Thrombocytopenia, Platelet Dysfunction, and Thrombocytosis: Assessment, Analysis, and Associated Dental Management Guidelines 155 17. Von Willebrand's Disease: Assessment, Analysis, and Associated Dental Management Guidelines 159 18. Coagulation Disorders: Common Clotting Factor Deficiency Disease States, Associated Systemic and/or Local Hemostasis Adjuncts, and Dental Management Guidelines 162 19. Anticoagulants Warfarin (Coumadin), Standard Heparin, and Low Molecular Weight Heparin (LMWH): Assessment, Analysis, and Associated Dental Management Guidelines 169 Section VI: Cardiology 175 20. Rheumatic fever (RF): Assessment, Analysis, and Associated Dental Management Guidelines 177 21. Infective Endocarditis and Current Premedication Prophylaxis Guidelines 181 22. Hypertension and Target Organ Disease States: Assessment, Analysis, and Associated Dental Management Guidelines 189 23. Cerebral Circulation Diseases TIAs and CVAs: Assessment, Analysis, and Associated Dental Management Guidelines 195 24. Coronary Circulation Diseases, Classic Angina and Myocardial Infarction: Assessment, Analysis, and Associated Dental Management Guidelines 197 25. Congestive Heart Failure (CHF): Assessment, Analysis, and Associated Dental Management Guidelines 202 26. Cardiac Arrhythmias: Assessment, Analysis, and Associated Dental Management Guidelines 204 27. Peripheral Circulation Disease 206 28. Renal Function Tests, Renal Disease, and Dialysis: Assessment, Analysis, and Associated Dental Management Guidelines 207 Section VII: Pulmonary Diseases 213 29. Pulmonary Function Tests and Sedation with Pulmonary Diseases: Assessment, Analysis, and Associated Dental Management Guidelines 215 30. Upper Airway Disease: Assessment, Analysis, and Associated Dental Management Guidelines 218 31. Asthma and Airway Emergencies: Assessment, Analysis, and Associated Dental Management Guidelines 220 32. Chronic Bronchitis: Assessment, Analysis, and Associated Dental Management Guidelines 226 33. Emphysema: Assessment, Analysis, and Associated Dental Management Guidelines 227 34. Chronic Obstructive Pulmonary Disease (COPD): Assessment, Analysis, and Associated Dental Management Guidelines 228 35. Obstructive Sleep Apnea (OSA): Assessment, Analysis, and Associated Dental Management Guidelines 232 36. Tuberculosis: Assessment, Analysis, and Associated Dental Management Guidelines 233 Section VIII: Clinical Pharmacology 239 37. Prescribed and Nonprescribed/Over-the-Counter Medications: Assessment, Analysis, and Associated Dental Management Guidelines 241 Section IX: Endocrinology 245 38. Diabetes: Type 1 and Type 2 Diabetes: Assessment, Analysis, and Associated Dental Management Guidelines 247 39. Thyroid Gland Dysfunctions, Hyperthyroidism and Hypothyroidism: Assessment, Analysis, and Associated Dental Management Guidelines 257 40. Adrenal Gland Cortex and Medulla Disease States: Assessment, Analysis, and Associated Dental Management Guidelines 261 41. Parathyroid Dysfunction Disease States: Assessment, Analysis, and Associated Dental Management Guidelines 268 42. Pituitary Gland Dysfunction: Acromegaly 272 Section X: Seizure Disorders 273 43. Classic Seizures, Petit Mal and Grand Mal Epilepsy: Assessment, Analysis, and Associated Dental Management Guidelines 275 Section XI: Gastrointestinal Conditions/Diseases 283 44. Gastrointestinal Disease States and Associated Oral Cavity Lesions: Assessment, Analysis, and Associated Dental Management Guidelines 285 Section XII: Hepatology 299 45. Liver Function Tests (LFTs), Hepatitis, and Cirrhosis: Assessment, Analysis, and Associated Dental Management Guidelines 301 Section XIII: Postexposure Prevention and Prophylaxis 325 46. Needle-Stick Exposure Protocol and Associated Management Prophylaxis in the Dental Setting 327 Section XIV: Infectious Diseases 331 47. Human Immunodefi ciency Virus (HIV) and Sexually Transmitted Diseases (STDs): Assessment, Analysis, and Associated Dental Management Guidelines 333 Section XV: Oral Lesions and Dentistry 349 48. Therapeutic Management of Oral Lesions in the Immune-Competent and the Immune-Compromised Patient in the Dental Setting 351 Section XVI: The Female Patient: Pregnancy, Lactation, and Contraception 371 49. Pregnancy and Lactation: Assessment and Associated Dental Management Guidelines 373 Section XVII: Rheumatology: Diseases of the Joints, Bones, and Muscles 385 50. Classic Rheumatic Diseases: Assessment of Disease States and Associated Dental Management Guidelines 387 Section XVIII: Oncology: Head and Neck Cancers, Leukemias, Lymphomas, and Multiple Myeloma 413 51. Head and Neck Cancers and Associated Dental Management Guidelines 415 Section XIX: Psychiatry 447 52. Psychiatric Conditions: Assessment of Disease States and Associated Dental Management Guidelines 449 Section XX: Transplants 465 53. Organ Transplants, Immunosuppressive Drugs, and Associated Dental Management Guidelines 467 Section XXI: Common Laboratory Tests 473 54. Comprehensive Metabolic Panel (CMP) and Common Hematological Tests 475 Appendix: Suggested Reading 479 Index 502