Dental Management Considerations of Organ Transplant Patients

Dental Management Considerations of Organ Transplant Patients

Pretransplantation considerations

• Significantly ill patient with end-organ damage
• Medical consultation required
• Consider postponing elective treatment
• Dental consultation prior to anticipated transplant:

Rule out dental infectious sources, definitively Perform necessary treatment; this will require consultation with trans-plantation physician to determine medical risk-to-benefit ratio

Obtain laboratory information/supplemental information as needed

Become acquainted with specific management issues (eg, blood products,prophylactic antibiotics) that may need to be employed if treatment is rendered.

Post-transplantation considerations

• Immediate post-transplantation period
• No elective dental treatment performed
• Emergency treatment only with medical consultation and consideration of specific management needs

Stable post-transplantation period

• Elective treatment may be performed after medical consultation with the transplantation physician
• Issues of immunosuppression must be recognized
• Oral mucosal disease must be diagnosed and treated
• Supplemental corticosteroids (steroid boost) may be necessary
• Consideration of antibiotic prophylaxis needed
• Consideration of specific management needs

Post-transplantation chronic rejection period

• Only emergency treatment
• Patients are very ill as they are immunosuppressed and have organ failure