Thursday, August 4, 2011

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

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