Evaluating and Managing Specific Medical Conditions in Dental Practice: A Review of Pre-Treatment Protocols
Main Article Content
Abstract
Oral health-related quality of life plays a crucial role in dental practice. Numerous systemic factors, including inadequate nutrition, tobacco use, stress, medication consumption, and diabetes, among others, have been demonstrated to affect oral health. Specific systemic treatments, such as chemo-radiotherapy for head and neck malignancies, cardiac valve replacement, bisphosphonate therapy, and allogeneic hematopoietic stem cell transplantation (HSCT), can impact oral health both during and after the primary treatment. Providing dental care for medically compromised individuals can be complex, particularly with regard to dental procedures and urgent care. An essential aspect of healthcare involves modifying dental treatments for patients whose medical conditions necessitate alterations. For these patients, dental examinations and clearances offer opportunities to deliver comprehensive preventive care that transcends professional boundaries. These consultations also provide occasions to propose treatment options before, during, and after dental visits. While numerous research studies have explored this topic, dental practitioners have not widely adopted it due to limited understanding of medical conditions. Given these clinical challenges, it is imperative to address and elucidate the dental clearance issue for common medical conditions frequently encountered in dental practice. Furthermore, there is a necessity to establish clinical protocols for assessment and management prior to medical procedures.
Keywords:
Radiotherapy, MRONJ, Bisphosphonate, allHSCT
Article Details
How to Cite
NANDA, Aditi et al.
Evaluating and Managing Specific Medical Conditions in Dental Practice: A Review of Pre-Treatment Protocols.
Medical Research Archives, [S.l.], v. 12, n. 10, oct. 2024.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/5929>. Date accessed: 22 dec. 2024.
doi: https://doi.org/10.18103/mra.v12i10.5929.
Section
Review Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
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4. Niwa H, Sato Y, Matsuura H. Safety of dental treatment in patients with previously diagnosed acute myocardial infarction or unstable angina pectoris. Oral Surg Oral Med Oral Pathol Oral RadiolEndod. 2000;89(1):35–41.
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7. Southerland JH, Gill DG, Gangula PR, Halpern LR, Cardona CY, Mouton CP. Dental management in patients with hypertension: challenges and solutions. Clin CosmetInvestig Dent. 2016;8:111–20.
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9. Lam DK, Jan A, Sándor GK, Clokie CM. Prevention of infective endocarditis: Revised guidelines from the American Heart Association and the implications for dentists. J Can Dent Assoc. 2008;74(5):449–53.
10. Farbod F, Kanaan H, Farbod J. Infective endocarditis and antibiotic prophylaxis prior to dental/oral procedures: latest revision to the guidelines by the American Heart Association published April 2007. Int J Oral Maxillofac Surg. 2009; 38: 626-31.
11. Herrick KR, Terrio JM, Herrick C. Medical Clearance for Common Dental Procedures. Am Fam Physician. 2021 Nov 1;104(5):476-483. PMID: 34783493.
12. Khamnil Y, Kao-Iean S, Pisarnturakit PP. Scale development to measure the patient perception of patient-centered care of dentists in primary care settings of Thailand: a measurement invariance test. BMC Oral Health. 2023 Sep 2;23(1):626. doi: 10.1186/s12903-023-03331-1. PMID: 37660040; PMCID: PMC10474778.
13. Appukuttan DP. Strategies to manage patients with dental anxiety and dental phobia: literature review. Clin CosmetInvestig Dent. 2016 Mar 10;8:35-50
14. Gatchell RJ, Ingersoll BD, Bowman L, Robertson MC, Walker C. The prevalence of dental fear and avoidance: a recent survey study. J Am Dent Assoc. 1983;107(4):609–610
15. Benjamin C, Schuurs AH, Kooreman T, Hoogstraten J. Self-reported and physiologically measured dental anxiety, coping styles and personality traits. Anxiety Stress Coping. 1996;9(2):151–162.
16. Baskar R, Lee KA, Yeo R, Yeoh KW. Cancer and radiation therapy: current advances and future directions. Int J Med Sci. 2012;9(3):193-9.
17. Alfouzan AF. Radiation therapy in head and neck cancer. Saudi Med J. 2021 Mar;42(3):247-254.
18. Jham BC, da Silva Freire AR. Oral complications of radiotherapy in the head and neck. Braz J Otorhinolaryngol. 2006 Sep-Oct;72(5):704-8.
19. Sroussi HY, Epstein JB, Bensadoun RJ, Saunders DP, Lalla RV, Migliorati CA, Heaivilin N, Zumsteg ZS. Common oral complications of head and neck cancer radiation therapy: mucositis, infections, saliva change, fibrosis, sensory dysfunctions, dental caries, periodontal disease, and osteoradionecrosis. Cancer Med. 2017 Dec;6(12):2918-2931.
20. Kawashita Y, Soutome S, Umeda M, Saito T. Oral management strategies for radiotherapy of head and neck cancer. Jpn Dent Sci Rev. 2020 Dec;56(1):62-67.
21. Beech N, Robinson S, Porceddu S, Batstone M. Dental management of patients irradiated for head and neck cancer. Aust Dent J. 2014 Mar;59(1):20-8.
22. Sonis ST, Woods PD, White BA: Oral complications of cancer therapies. Pretreatment oral assessment. NCI Monogr (9): 29-32, 1990.
23. Brown TJ, Gupta A. Management of Cancer Therapy-Associated Oral Mucositis. JCO Oncol Pract. 2020 Mar;16(3):103-109.
24. Murdoch-Kinch CA, Zwetchkenbaum S. Dental management of the head and neck cancer patient treated with radiation therapy. J Mich Dent Assoc. 2011 Jul;93(7):28-37.
25. Chin DWH, Treister N, Friedland B, Cormack RA, Tishler RB, Makrigiorgos GM, Court LE. Effect of dental restorations and prostheses on radiotherapy dose distribution: a Monte Carlo study. J Appl Clin Med Phys. 2009 Feb 03;10(1):80-89.
26. Devi S, Singh N. Dental care during and after radiotherapy in head and neck cancer. Natl J Maxillofac Surg. 2014 Jul-Dec;5(2):117-25.
27. Gupta N, Pal M, Rawat S, Grewal MS, Garg H, Chauhan D, Ahlawat P, Tandon S, Khurana R, Pahuja AK, Mayank M, Devnani B. Radiation-induced dental caries, prevention and treatment - A systematic review. Natl J Maxillofac Surg. 2015 Jul-Dec;6(2):160-6. [
28. Palmier NR, Migliorati CA, Prado-Ribeiro AC, de Oliveira MCQ, Vechiato Filho AJ, de Goes MF, Brandão TB, Lopes MA, Santos-Silva AR. Radiation-related caries: current diagnostic, prognostic, and management paradigms. Oral Surg Oral Med Oral Pathol Oral Radiol. 2020 Jul;130(1):52-62.
29. Goh, E., Beech, N., Johnson, N. et al. The dental management of patients irradiated for head and neck cancer. Br Dent J 234, 800–804 (2023).
30. Buurman, Doke J.M. et al. The extent of unnecessary tooth loss due to extractions prior to radiotherapy based on radiation field and dose in patients with head and neck cancer. Radiotherapy and Oncology 187 (2023) 109847
31. Rogers SN et al. Variations in concerns reported on the patient concerns inventory in patients with head and neck cancer from different health settings across the world. Head Neck Mar 2020;42:498–512
32. Jansma J et al. Protocol for the prevention and treatment of oral sequelae resulting from head and neck radiation therapy. Cancer Oct 15 1992;70:2171–80.
33. Mensah G.A., Roth G.A., Fuster V. The global burden of cardiovascular diseases and risk factors: 2020 and beyond. J Am Coll Cardiol. 2019;74:2529–2532.
34. Margaix-Muñoz M, Jiménez-Soriano Y, Poveda-Roda R, Sarrión G. Cardiovascular diseases in dental practice. Practical considerations. Med Oral Patol Oral Cir Bucal. 2008; 13: 296-302.
35. Lifshey FM. Evaluation of and Treatment Considerations for the Dental Patient with Cardiac Disease. NYSDJ. 2004
36. Steinhauer T, Bsoul SA, Terezhalmy GT. Risk stratification and dental management of the patient with cardiovascular diseases. Part I: Etiology, epidemiology and principles of medical management. Quintessence Int. 2005; 36: 119-37.
37. Silvestre-Donat FJ. Dental management of heart disease. Medicina Oral. 2003; 8: 230 29. Becker DE. Preoperative Medical Evaluation: Part 1: General Principles and Cardiovascular Considerations. Anesth Prog. 2009; 56: 92-103.
38. Jowett NI, Cabot LB. Patients with cardiac disease: considerations for the dental practitioner. Br Dent J 2000;189:297–302.
39. Nath SS, Parashar S. Perioperative management of patients with prosthetic heart valves-A narrative review. Ann Card Anaesth. 2022 Jul-Sep;25(3):254-263.
40. Thornhill M, Prendergast B, Dayer M, et al. Prevention of infective endocarditis in at-risk patients: how should dentists proceed in 2024? Br Dent J. 2024 May;236(9):709-716.
41. Rose LF, Mealey B, Minsk L, Cohen DW. Oral care for patients with cardiovascular disease and stroke. J Am Dent Assoc 2002;133(Suppl)):37S–44S.
42. Sedghi L, DiMassa V, Harrington A, Lynch SV, Kapila YL. The oral microbiome: Role of key organisms and complex networks in oral health and disease. Periodontol 2000. 2021 Oct;87(1):107-131.
43. Vytla S, Gebauer D. Clinical guideline for the management of odontogenic infections in the tertiary setting. Aust Dent J. 2017 Dec;62(4):464-470.
44. Little JW, Miller CS, Rhodus NL. Ischemic heart disease. In: Dental management of the medically compromised patient 4. St. Louis, MO: Elsevier; 2018. p. 53–69.
45. Kuzekanani M, Gutmann JL. Latest concepts in the endodontic management of patients with cardiovascular disorders. EurEndod J 2019;4:86–9. doi: 10.14744/eej.2019.70288.
46. Cruz-Pamplona M, Jimenez Y, Perez MG. Dental considera- tions in patients with heart disease. J Clin Exp Dent 2011;3: e97–e105.
47. Singh S, Gupta K, Garg K, Fuloria N, Fuloria S, Jain T. Dental management of the cardiovascular compromised patient: a clinical approach. J Young Pharm 2017;9:453–6.
48. Drake MT, Clarke BL, Khosla S. Bisphosphonates: mechanism of action and role in clinical practice. Mayo Clin Proc. 2008 Sep;83(9):1032-45.
49. Russell RG. Bisphosphonates: mode of action and pharmacology. Pediatrics. 2007;119 (Suppl 2):S150-S162.
50. Russell RG, Xia Z, Dunford JE, et al. An update on mechanisms of action and how these relate to clinical efficacy. Ann N Y Acad Sci. 2007;1117:209-257.
51. Scottish Dental Clinical Effectiveness Program. Oral Health Management of Patients at Risk of Medication-related Osteonecrosis of the Jaw: Dental Clinical Guidance. March 1, 2017.
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