Home > ORAL HEALTH > General > Keep The Dentist Informed About Your Medical Problems

Keep The Dentist Informed About Your Medical Problems

Introduction

At your first dental visit, you will be asked to provide information regarding your medical history. The medical history should include past and present medical conditions, any hospitalization or surgery, known case of allergies (such as drug allergy, latex allergy or seafood allergy) and medications.

You might question the reason as to why it is crucial to notify your medical problems to the attending dentist or dental provider. This is necessary because your medical problem can potentially have unwanted impacts either directly or indirectly on the oral health status. The information that you provide is beneficial for the professional to formulate treatment plans suitable for patients with such medical problems.

It is also necessary to inform your dentist about all the medications that you are currently taking. This is because some medications may present with side-effects. It would be good to keep a list of medications you are on in your purse or wallet for convenience.

Sometimes, dental treatment need to be modified based on the individuals’ needs and medical history.

MEDICAL PROBLEM
IMPACT ON DENTAL TREATMENT
Hypertension
  • Prolonged bleeding may occur after tooth extraction or surgery in uncontrolled hypertension.
  • Your level of blood pressure can increase due to stress and anxiety from dental treatment.
  • Those who are on antihypertensive medications may develop postural hypotension which is dizziness if you get up too quickly from the dental chair.
  • May experience oral side effects from antihypertensive medications, e.g.:
    • Beta blockers: dry mouth and lichenoid reaction.
    • Calcium antagonist: enlargement of gum tissues.
    • ACE inhibitors: angioedema and lichenoid reaction.
Diabetes
  • Poor wound healing and increased risk of infection especially in uncontrolled diabetes.
  • If you start to feel differently during dental treatment (e.g.: trembling, hunger, headache, sweating or “pins and needles” in lips and tongue), you need to tell your dentist immediately. You may be experiencing hypogylcaemia (low level of blood sugar) thus requiring immediate medical emergency care.
  • May experience oral side-effects from diabetes :
    • Accelerated gum (periodontal) diseases.
    • Dry mouth.
    • Candidiasis (oral fungal infection).
    • Numbness, burning or pain sensations around the oral cavity and tissues.

Figure 1: A diabetic patient with history of colorectal cancer and who is also a moderate cigarette smoker presents with worn down teeth and inflammed palate.

Heart Problems
  • Your dentist may need to prescribe antibiotics before certain dental procedures.

  • Prolonged bleeding may occur after scaling, tooth extraction or surgical procedures if you are on anticoagulant medications such as Warfarin and Heparin.

  • You may not have to stop your anti-platelet medication such as Aspirin and Clopidogrel for certain dental procedures, however, please consult your dentist first.

  • If you had heart surgery within the last six (6) months, please inform your dentist. Modifications of dental treatment are required and hospital referral is indicated.

  • If you start to feel severe and tightening chest pain, shortness of breath, nausea and vomiting, please inform your dentist immediately. You may be experiencing heart attack which warrants immediate medical emergency care.

  • Please ensure you bring your emergency heart medications during your dental visit.

Bleeding disorders
  • Prolonged and excessive bleeding, infection and delayed healing may occur after scaling, tooth extraction or surgical procedures which can lead to serious complications and premature death.

  • Spontaneous bleeding in the oral cavity can potentially occur.

  • Ideally, patients with bleeding disorders should be managed in a dental facility within hospital setting.

Hepatitis
  • Caution must be exercised due to potential risk of cross-infection.

  • Prolonged bleeding may occur after scaling, tooth extraction or surgical procedures especially with chronic active hepatitis.

  • Please consult your dentist first before taking any medications as hepatitis can affect the metabolism of drugs in the liver.

HIV/AIDS
  • Caution must be exercised due to potential risk of cross-infection
  • Modifications of dental treatment are required as the defense mechanism of the body is compromised and may also require referral to a dental facility within hospital setting.
  • May experience oral signs and symptoms:
    • Accelerated gum (periodontal) diseases.

    • Dry mouth.

    • Candidiasis (oral fungal infection).

Steroid based medication (e.g.: Prednisolone)
  • If you are currently taking or have taken this drug within the past twelve (12) months, please inform your dentist.
  • Supplementary dose of steroids may be required for routine dental treatment. Please consult with your dentist.
Bisphosphonate medication
[e.g: Alendronate(Fosamax) or Zoledronic Acid (Zometa) }
  • If you are currently taking or have previously taken this drug, please inform your dentist.
  • Modifications of dental treatment especially for teeth extraction or dental surgical procedures may be required due to potential risk of poor bone healing.
Allergic to medications (especially to antibiotics and painkillers)
  • If you have previous history of allergic reactions (e.g.: rashes, hives, itching or swelling on the lips or throats) from certain drugs or medications, it is important that you inform your dentist about this. This will prevent the dentist from prescribing the same group of drugs or medications that you are allergic to.


Figure 2: Severe caries caused by dry mouth.

References

  1. M.Greenwood & J.G.Meechan. General medicine and surgery for dental practitioners Part: Cardiovascular system. Br Dent J 2003; 194: 537-542
  2. Scully C, Dios P.D, Kumar N. (2006). Special Care in Dentistry: Handbook of Oral HealthCare. Churchill Livingstone.
Last Reviewed : 10 June 2014
Writer : Dr. Norjehan bt. Yahaya
Accreditor / Reviewer : Dr. Siti Zaleha bt. Hamzah