A medically compromised condition is one in which the patient suffers from a certain systemic condition that puts him at a risk when regular dental treatment is required. If you suffer from one of these conditions, your doctor has to take certain precautions to enable you to go through the treatment without complications.
For Heart Patients
• Prior to treatment, give a complete medical history to your dentist. Consultation with a heart specialist is necessary to determine the ability to tolerate the planned dental treatment, and complications that can arise. In addition antibiotics should be prescribed.
• Gum bleeding is likely to take place during dental procedures like scaling, minor surgeries, etc.; therefore, stick to your doctor’s instructions of taking antibiotic prophylaxis.
Dental procedures that do not require prior antibiotics include those which may not induce gum bleeding, such as simple orthodontic appliances, filling above the gum line, and injection of local anesthetics.
• Pulp therapy of baby teeth is not recommended, due to a high risk of chronic infection. Instead, extraction of the offending tooth and its replacement with a space maintainer is recommended.
• In permanent teeth, root canal treatment may be taken after careful evaluation and case selection (a tooth with a poor prognosis is better removed).
• You can ask your dentist for oral sedation and painkillers which may be beneficial in reducing anxiety and minimizing risks.
• If you are taking anticoagulant therapy, get your blood test done and inform your dentist, so that your anticoagulant therapy can be ceased.
• Children suffering from severe heart disease requiring extensive dental work should be treated in a hospital under general anesthesia.
For Diabetes Patients
Diabetes mellitus is most common endocrine disease. It is often associated with an inadequate supply of a hormone called insulin to meet the physiological needs of the body. Oral symptoms include reduced salivary flow, burning mouth or tongue, fungal infection, altered taste, dental decay, gum disease, oral neuropathies, parotid enlargement, delayed wound healing, etc.
• Dental management is aimed at implementation of preventive protocol, symptomatic relief of any oral disease, and immediate primary care.
• Give your doctor a complete medical history, along with screening tests for blood sugar level.
• Try to keep your appointment with the dentist short and stress free as possible.
• Early morning appointments are preferred, and you should eat a normal breakfast before the appointment, to prevent hypoglycaemia.
• In children, pulp therapy may be preferred to a stressful extraction procedure under local anesthesia.
• Prophylactic antibiotic may be recommended in use of surgical procedures.
It has been reported that a well-controlled, otherwise healthy diabetic experiences a normal or even reduced level of dental decay, which has been attributed to restriction of sugar and carbohydrates, effective metabolic control, good oral hygiene, and regular dental check-up. Dietary control is often difficult to enforce, and frequent snacking, elevated salivary sugar, and decreased salivary flow may be responsible for increasing dental decay in uncontrolled diabetic patients.
Keeping all the above points in mind, and cooperating with your dentist, will surely help you go through your dental visits successfully.