Dentists Guide to Medical Conditions, Medications and Complications

Dentist’s Guide to Medical Conditions, Medications, and Complications, Second Edition, is a highly accessible reference to dental treatment of patients with common systemic conditions and medical complications, providing readers with a thorough reference to dental treatment in a whole–patient context. This updated and expanded editionoutlines protocols for treating patients with common conditions, presents essential drug interaction information, and guides the dental professional through the prevention and management of in–office medical emergencies. Dentist’s Guide to Medical Conditions, Medications, and Complications, Second Edition, first examines broader subjects, such as pharmacology commonly used in dentistry and its interactions with other commonly prescribed drugs, patient assessment, and acute care and stress management. The book then proceeds to examine each common medical condition in turn. Numerous helpful tools for organization and reference are featured, allowing readers to access information easily on the particular condition or complication being encountered by their patients. Explanations are given succinctly and concisely on how to manage the practicalities of dental treatment. Related conditions are cross–referenced, to allow readers to navigate the topic easily. Checklists, forms, and other resources are also provided. Systematic, thorough, and above all, useful, Dentist’s Guide to Medical Conditions, Medications, and Complications, Second Edition, provides practicing dentists, dental students, and dental hygienists with an essential resource and a practical tool for better practice. Updated medical information and treatments for diabetes, hypertension, hepatitis C, bisphosphonates and ONJ, and more Highlights what a dentist needs to know about common medical conditions, complications, and pharmacology Presents essential drug interaction information in a concise, user–friendly format Provides universal abbreviations for physical examination Guides the dental professional on the prevention and management of in–office medical emergencies

Acknowledgments xii Introduction: Integration of Medicine in Dentistry xiv Section I: Patient Assessment 1 1. Routine History–Taking and Physical Examination 3 2. History and Physical Assessment of the Medically Complex Dental Patient 24 Section II: Pharmacology 33 3. Essentials in Pharmacology: Drug Metabolism, Cytochrome P450 Enzyme System, and Prescription Writing 35 4. Local Anesthetics Commonly Used in Dentistry: Assessment, Analysis, and Associated Dental Management Guidelines 54 5. Pain Physiology, Analgesics, Opioid Dependency Maintenance Therapies, Multimodal Analgesia, and Pain Management Algorithms 67 6. Odontogenic Infections, Antibiotics, and Infection Management Protocols 110 7. Antifungals Commonly Used in Dentistry: Assessment, Analysis, and Associated Dental Management Guidelines 150 8. Antivirals Commonly Used in Dentistry: Assessment, Analysis, and Associated Dental Management Guidelines 155 Section III: Acute Care and Stress Management 159 9. Management of Medical Emergencies: Assessment, Analysis, and Associated Dental Management Guidelines 161 10. Oral and Parenteral Conscious Sedation for Dentistry: Assessment, Analysis, and Associated Dental Management Guidelines 183 Section IV: Hematopoietic System 199 11. Complete Blood Count: Assessment, Analysis, and Associated Dental Management Guidelines 201 12. Red Blood Cells Associated Disorder: Anemia: Assessment, Analysis, and Associated Dental Management Guidelines 209 13. Red Blood Cells Associated Disorder: Polycythemia: Assessment, Analysis, and Associated Dental Management Guidelines 222 14. Red Blood Cells Associated Disorder: Hemochromatosis: Assessment, Analysis, and Associated Dental Management Guidelines 225 Section V: Hemostasis and Associated Bleeding Disorders 229 15. Primary and Secondary Hemostasis: Normal Mechanisms, Disease States, and Coagulation Tests: Assessment, Analysis, and Associated Dental Management Guidelines 231 16. Platelet Disorders: Thrombocytopenia, Platelet Dysfunction, and Thrombocytosis: Assessment, Analysis, and Associated Dental Management Guidelines 243 17. VonWillebrand’s Disease: Assessment, Analysis, and Associated Dental Management Guidelines 250 18. Coagulation Disorders: Common Clotting Factor Deficiency Disease States, Associated Systemic and/or Local Hemostasis Adjuncts, and Dental Management Guidelines 254 19. Anticoagulants: Assessment, Analysis, and Associated Dental Management Guidelines 262 Section VI: Cardiology and Renal Disease 273 20. Rheumatic Fever: Assessment, Analysis, and Associated Dental Management Guidelines 275 21. Infective Endocarditis and Current Premedication Prophylaxis Guidelines 279 22. Hypertension and Target Organ Disease States: Assessment, Analysis, and Associated Dental Management Guidelines 288 23. Cerebral Circulation Diseases TIAs and CVAs: Assessment, Analysis, and Associated Dental Management Guidelines 300 24. Coronary Circulation Diseases, Classic Angina, and Myocardial Infarction: Assessment, Analysis, and Associated Dental Management Guidelines 302 25. Congestive Heart Failure: Assessment, Analysis, and Associated Dental Management Guidelines 311 26. Cardiac Arrhythmias: Assessment, Analysis, and Associated Dental Management Guidelines 315 27. Peripheral Circulation Disease 318 28. Renal Function Tests, Renal Disease, and Dialysis: Assessment, Analysis, and Associated Dental Management Guidelines 319 Section VII: Pulmonary Diseases 331 29. Pulmonary Function Tests and Sedation with Pulmonary Diseases: Assessment, Analysis, and Associated Dental Management Guidelines 333 30. Upper Airway Disease: Allergic Rhinitis, Sinusitis, and Streptococcal Pharyngitis: Assessment, Analysis, and Associated Dental Management Guidelines 337 31. Asthma and Airway Emergencies: Assessment, Analysis, and Associated Dental Management Guidelines 341 32. Chronic Bronchitis and Smoking Cessation 348 33. Emphysema: Assessment, Analysis, and Associated Dental Management Guidelines 356 34. Chronic Obstructive Pulmonary Disease: Assessment, Analysis, and Associated Dental Management Guidelines 358 35. Obstructive Sleep Apnea: Assessment, Analysis, and Associated Dental Management Guidelines 365 36. Tuberculosis: Assessment, Analysis, and Associated Dental Management Guidelines 367 Section VIII: Clinical Pharmacology 375 37. Prescribed and Nonprescribed Medications: Assessment, Analysis, and Associated Dental Management Guidelines 377 Section IX: Endocrinology 383 38. Introduction to Endocrinology and Diabetes: Assessment, Analysis, and Associated Dental Management Guidelines 385 39. Thyroid Gland Dysfunctions: Assessment, Analysis, and Associated Dental Management Guidelines 403 40. Adrenal Gland Disease States: Assessment, Analysis, and Associated Dental Management Guidelines 408 41. Parathyroid Dysfunction Disease States: Assessment, Analysis, and Associated Dental Management Guidelines 417 42. Growth Hormone Dysfunction and Endocrine Tissues of the Reproductive System 433 Section X: Seizure Disorders 437 43. Classic Seizures: Assessment, Analysis, and Associated Dental Management Guidelines 439 Section XI: Gastrointestinal Conditions and Diseases 447 44. Gastrointestinal Disease States and Associated Oral Cavity Lesions: Assessment, Analysis, and Associated Dental Management Guidelines 449 Section XII: Hepatology 465 45. Liver Function Tests, Hepatitis, and Cirrhosis: Assessment, Analysis, and Associated Dental Management Guidelines 467 Section XIII: Postexposure Prevention and Prophylaxis 493 46. Needle–Stick Exposure Protocol and CDC Recommendations for Dental Health–Care Providers Infected with the Hepatitis B Virus 495 Section XIV: Infectious Diseases 503 47. Human Immunodeficiency Virus, Herpes Simplex and Zoster, Lyme Disease, MRSA Infection, and Sexually Transmitted Diseases 505 Section XV: Oral Lesions and Dentistry 539 48. Therapeutic Management of Oral Lesions in the Immune–Competent and the Immune–Compromised Patient in the Dental Setting 541 Section XVI: The Female Patient: Pregnancy, Lactation, and Contraception 565 49. Pregnancy, Lactation, and Contraception: Assessment and Associated Dental Management Guidelines 567 Section XVII: Rheumatology: Diseases of the Joints, Bones, and Muscles 587 50. Classic Rheumatic Diseases: Assessment and Associated Dental Management Guidelines 589 Section XVIII: Oncology: Head and Neck Cancers, Leukemias, Lymphomas, and Multiple Myeloma 625 51. Head and Neck Cancers and Associated Dental Management Guidelines 627 Section XIX: Psychiatry 661 52. Psychiatric Conditions: Assessment of Disease States and Associated Dental Management Guidelines 663 Section XX: Transplants 683 53. Organ Transplants, Immunosuppressive Drugs, and Associated Dental Management Guidelines 685 Section XXI: Common Laboratory Tests 695 54 Comprehensive Metabolic Panel and Common Hematological Tests 697 Appendix: Suggested Reading 699 Index 743

Kanchan Ganda, MD, 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.