BOOK
Dental Management of the Medically Compromised Patient - E-Book
James W. Little | Donald Falace | Craig Miller | Nelson L. Rhodus
(2017)
Additional Information
Book Details
Abstract
Learn how to provide dental care to any patient, regardless of existing medical conditions. Little and Falace’s Dental Management of the Medically Compromised Patient, 9th Edition, has been thoroughly revised to give you the information you need to assess common problems, and make safe and healthy dental management decisions. The new addition includes expanded coverage of women’s health issues and introduces a process for developing a medical-risk source. Also, each chapter features vivid illustrations and well-organized tables to give you in-depth details and overall summaries to help you get to the root of your future patients’ needs.
- Logical organization of conditions makes it easy for you to understand and follow the material as you prepare to treat patients.
- Standardized assessment process helps you to ascertain the severity and stability of common medical disorders.
- Dental management summary table summarizes important factors for consideration in the dental management of medically compromised patients.
- Over 400 color images provide a visual guide and highlight key information.
- Dental management box in each chapter allows you to locate key information for evaluating a medically compromised patient.
- NEW! Thoroughly revised content provides you with the most current, evidence-based information you need to make dental management decisions.
- NEW! Evidence-based process for creating a medical-risk score enables you to determine whether the benefit of treatment outweighs the risk of a complication.
- NEW! Expanded coverage of women’s health issues addresses issues specific to women that can impact dental management.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | cover | ||
| Inside Front Cover | ifc1 | ||
| Half title page | i | ||
| Evolve page | ii | ||
| Little and Falace's Dental Management of the Medically Compromised Patient | iii | ||
| Copyright Page | iv | ||
| Dedication | v | ||
| Foreword | vii | ||
| References | viii | ||
| Preface | ix | ||
| New to This Edition | ix | ||
| Table Of Contents | xi | ||
| Dental Management: A Summary | xiii | ||
| I Patient Evaluation and Risk Assessment | 1 | ||
| 1 Patient Evaluation and Risk Assessment | 2 | ||
| Medical History | 2 | ||
| Cardiovascular Disease | 2 | ||
| Heart Failure. | 2 | ||
| Heart Attack. | 3 | ||
| Angina Pectoris. | 4 | ||
| High Blood Pressure. | 4 | ||
| Heart Murmur. | 4 | ||
| Mitral Valve Prolapse. | 4 | ||
| Rheumatic Fever. | 4 | ||
| Congenital Heart Disease. | 4 | ||
| Artificial Heart Valve. | 4 | ||
| Arrhythmias. | 4 | ||
| Coronary Artery Bypass Graft, Angioplasty, or Stent. | 5 | ||
| Hematologic Disorders | 5 | ||
| Hemophilia or Inherited Bleeding Disorder. | 5 | ||
| Blood Transfusion | 5 | ||
| Anemia | 5 | ||
| Leukemia and Lymphoma | 5 | ||
| Taking a “Blood Thinner” or the Tendency to Bleed Longer Than Normal | 5 | ||
| Neurologic Disorders | 5 | ||
| Stroke. | 5 | ||
| Epilepsy, Seizures, and Convulsions. | 6 | ||
| Behavioral Disorders and Psychiatric Treatment. | 6 | ||
| Gastrointestinal Diseases | 6 | ||
| Stomach or Intestinal Ulcers, Gastritis, and Colitis. | 6 | ||
| Hepatitis, Liver Disease, Jaundice, and Cirrhosis. | 6 | ||
| Respiratory Tract Disease | 6 | ||
| Allergies or Hives. | 6 | ||
| Asthma. | 6 | ||
| Emphysema and Chronic Bronchitis. | 6 | ||
| Tuberculosis. | 6 | ||
| Sleep Apnea and Snoring. | 7 | ||
| Musculoskeletal Disease | 7 | ||
| Arthritis. | 7 | ||
| Prosthetic Joints. | 7 | ||
| Endocrine Disease | 7 | ||
| Diabetes. | 7 | ||
| Thyroid Disease. | 7 | ||
| Genitourinary Tract Disease | 7 | ||
| Kidney Failure. | 7 | ||
| Sexually Transmitted Diseases. | 7 | ||
| Other Conditions and Factors | 8 | ||
| Tobacco and Alcohol Use. | 8 | ||
| Drug Addiction and Substance Abuse. | 8 | ||
| Tumors and Cancer. | 8 | ||
| Radiation Therapy and Chemotherapy. | 8 | ||
| Steroids. | 8 | ||
| Operations or Hospitalizations. | 8 | ||
| Pregnancy. | 8 | ||
| Current Physician | 8 | ||
| Drugs, Medicines, or Pills | 8 | ||
| Functional Capacity | 9 | ||
| Physical Examination | 9 | ||
| General Appearance | 9 | ||
| Skin and Nails. | 9 | ||
| Face. | 10 | ||
| Eyes. | 10 | ||
| Ears. | 10 | ||
| Neck. | 11 | ||
| Vital Signs | 11 | ||
| Pulse. | 12 | ||
| Rate. | 13 | ||
| Rhythm. | 13 | ||
| Blood Pressure. | 13 | ||
| Respiration. | 14 | ||
| Temperature. | 14 | ||
| Height. | 14 | ||
| Weight. | 14 | ||
| Head and Neck Examination | 14 | ||
| Clinical Laboratory Tests | 14 | ||
| Physician Referral and Consultation | 15 | ||
| Problem List and Diagnoses | 15 | ||
| Risk Assessment | 15 | ||
| Age | 16 | ||
| Treatment Modifications | 16 | ||
| Stress and Anxiety Reduction | 17 | ||
| References | 17 | ||
| II Cardiovascular Disease | 18 | ||
| 2 Infective Endocarditis | 19 | ||
| Definition | 19 | ||
| Complications | 19 | ||
| Epidemiology | 19 | ||
| Etiology | 21 | ||
| Pathophysiology and Complications | 21 | ||
| Clinical Presentation | 23 | ||
| Signs and Symptoms | 23 | ||
| Laboratory and Diagnostic Findings | 25 | ||
| Medical Management | 25 | ||
| Dental Management | 27 | ||
| Antibiotic Prophylaxis | 27 | ||
| Source and Frequency of Bacteremia. | 27 | ||
| Magnitude of Bacteremia. | 28 | ||
| Bleeding and Bacteremia | 29 | ||
| Efficacy of Antibiotic Prophylaxis. | 29 | ||
| Risk of Bacterial Endocarditis Due to Dental Procedures. | 29 | ||
| Current American Heart Association Recommendations (2007) | 30 | ||
| Patients Recommended to Receive Antibiotic Prophylaxis | 30 | ||
| Dental Procedures for Which Antibiotic Prophylaxis Is Recommended | 31 | ||
| Antibiotic Prophylaxis Regimens | 31 | ||
| Special Situations | 32 | ||
| Patients Already Taking Antibiotics. | 32 | ||
| Patients Undergoing Cardiac Surgery. | 32 | ||
| Prolonged Dental Appointment. | 32 | ||
| Other Considerations | 32 | ||
| Implementation of the Recommendations | 32 | ||
| Nonvalvular Cardiovascular Devices | 33 | ||
| Intravascular Catheters | 33 | ||
| References | 34 | ||
| 3 Hypertension | 38 | ||
| Epidemiology | 38 | ||
| Etiology | 39 | ||
| Pathophysiology and Complications | 39 | ||
| Clinical Presentation | 40 | ||
| Signs and Symptoms | 40 | ||
| Laboratory and Diagnostic Findings | 41 | ||
| Medical Management | 41 | ||
| Dental Management | 44 | ||
| Medical Considerations | 44 | ||
| Identification. | 44 | ||
| Risk Assessment. | 46 | ||
| Recommendations | 46 | ||
| Antibiotics. | 46 | ||
| Bleeding. | 47 | ||
| Blood Pressure. | 47 | ||
| Capacity to Tolerate Care. | 47 | ||
| Chair. | 48 | ||
| Drug Considerations. | 48 | ||
| Use of Vasoconstrictors. | 48 | ||
| Drug Interactions. | 49 | ||
| Oral Manifestations. | 50 | ||
| References | 50 | ||
| 4 Ischemic Heart Disease | 53 | ||
| Epidemiology | 53 | ||
| Etiology | 53 | ||
| Pathophysiology and Complications | 54 | ||
| Clinical Presentation | 56 | ||
| Symptoms | 56 | ||
| Signs | 58 | ||
| Laboratory and Diagnostic Findings | 58 | ||
| Medical Management | 58 | ||
| Angina Pectoris | 58 | ||
| Myocardial Infarction | 61 | ||
| Dental Management | 63 | ||
| Medical Considerations | 63 | ||
| Identification. | 63 | ||
| Risk Assessment. | 63 | ||
| Recommendations. | 64 | ||
| Antibiotics: Infection Risk. | 65 | ||
| Bleeding. | 65 | ||
| Capacity to Tolerate Care. | 65 | ||
| Chair. | 66 | ||
| Drug Considerations. | 66 | ||
| Drug Interactions. | 67 | ||
| Oral Manifestations | 67 | ||
| References | 67 | ||
| 5 Cardiac Arrhythmias | 70 | ||
| Epidemiology | 70 | ||
| Etiology | 70 | ||
| Pathophysiology and Complications | 71 | ||
| Supraventricular Arrhythmias | 72 | ||
| Sinus Nodal Disturbances | 72 | ||
| Disturbances of Atrial Rhythm | 73 | ||
| Tachycardias Involving the Atrioventricular Junction | 73 | ||
| Heart Block | 73 | ||
| Ventricular Arrhythmias | 74 | ||
| Disorders of Repolarization | 74 | ||
| Clinical Presentation | 74 | ||
| Signs and Symptoms | 74 | ||
| Laboratory and Diagnostic Findings | 74 | ||
| Medical Management | 74 | ||
| Antiarrhythmic Drugs. | 75 | ||
| Oral Anticoagulant (OAC) Therapy. | 75 | ||
| Implanted Permanent Pacemakers. | 75 | ||
| Implantable Cardioverter-Defibrillators | 76 | ||
| Electromagnetic Interference. | 77 | ||
| Radiofrequency Catheter Ablation. | 77 | ||
| Surgery | 78 | ||
| Cardioversion and Defibrillation | 78 | ||
| Dental Management | 78 | ||
| Medical Considerations | 78 | ||
| Identification. | 78 | ||
| Risk Assessment. | 79 | ||
| Recommendations | 80 | ||
| Antibiotics: Infection Risk. | 80 | ||
| Appointment Scheduling. | 80 | ||
| Bleeding: Warfarin (Coumadin). | 80 | ||
| Dabigatran (Pradaxa), Rivaroxaban (Xarelto), Apixaban (Eliquis), or Edoxaban (Savaysa). | 80 | ||
| Capacity to Tolerate Care. | 82 | ||
| Drug Considerations | 82 | ||
| Use of Vasoconstrictors. | 82 | ||
| Digoxin Toxicity. | 82 | ||
| Drug Interactions. | 82 | ||
| Devices: Pacemakers and Implanted Cardioverter-Defibrillators ICDs and Electromagnetic Interference | 82 | ||
| Oral Manifestations | 83 | ||
| References | 83 | ||
| 6 Heart Failure (or Congestive Heart Failure) | 86 | ||
| Epidemiology | 86 | ||
| Pathophysiology and Complications | 86 | ||
| Clinical Presentation | 90 | ||
| Laboratory and Diagnostic Findings | 91 | ||
| Medical Management | 92 | ||
| Dental Management | 95 | ||
| Identification. | 95 | ||
| Risk Assessment. | 95 | ||
| Recommendations (see Box 6.7) | 97 | ||
| Antibiotics. | 97 | ||
| Anxiety. | 97 | ||
| Analgesics. | 97 | ||
| Bleeding. | 97 | ||
| Blood Pressure. | 97 | ||
| Chair Position. | 97 | ||
| Consultation. | 97 | ||
| Drug Considerations. | 97 | ||
| Devices. | 97 | ||
| Equipment. | 97 | ||
| Emergencies. | 97 | ||
| Oral Manifestations and Complications | 97 | ||
| References | 98 | ||
| III Pulmonary Disease | 100 | ||
| 7 Pulmonary Disease | 101 | ||
| Chronic Obstructive Pulmonary Disease | 101 | ||
| Epidemiology | 101 | ||
| Etiology | 101 | ||
| Pathophysiology and Complications | 101 | ||
| Clinical Presentation | 102 | ||
| Signs and Symptoms | 102 | ||
| Laboratory and Diagnostic Findings | 102 | ||
| Medical Management | 104 | ||
| Dental Management | 105 | ||
| Prevention of Potential Problems | 105 | ||
| Identification. | 105 | ||
| Risk Assessment. | 105 | ||
| Recommendations | 105 | ||
| Airway and Breathing. | 105 | ||
| Capacity to Tolerate Care. | 105 | ||
| Chair Position. | 107 | ||
| Drug Considerations. | 107 | ||
| Oral Complications and Manifestations | 108 | ||
| Asthma | 108 | ||
| Epidemiology | 108 | ||
| Etiology | 109 | ||
| Pathophysiology and Complications | 109 | ||
| Clinical Presentation | 111 | ||
| Signs and Symptoms | 111 | ||
| Laboratory and Diagnostic Findings | 111 | ||
| Classification | 111 | ||
| Medical Management | 112 | ||
| Dental Management | 113 | ||
| Identification and Prevention. | 113 | ||
| Risk Assessment. | 113 | ||
| Recommendations | 113 | ||
| Appointment, Airway, and Breathing. | 113 | ||
| Capacity to Tolerate Care. | 115 | ||
| Drug Considerations. | 115 | ||
| Emergency (Asthma Attack). | 115 | ||
| Oral Complications and Manifestations | 115 | ||
| Tuberculosis | 116 | ||
| Epidemiology | 116 | ||
| Etiology | 116 | ||
| Pathophysiology and Complications | 117 | ||
| Clinical Presentation | 118 | ||
| Signs and Symptoms | 118 | ||
| Laboratory and Diagnostic Findings | 118 | ||
| Medical Management | 119 | ||
| Dental Management | 120 | ||
| Identification. | 120 | ||
| Risk Assessment. | 121 | ||
| Patients With Clinically Active Sputum-Positive Tuberculosis. | 121 | ||
| Patients With a Past History of Tuberculosis. | 122 | ||
| Patients With a Positive Tuberculin Test or Positive IGRA. | 122 | ||
| Patients With Signs or Symptoms Suggestive of TB. | 122 | ||
| Recommendations | 122 | ||
| Airway and Breathing. | 122 | ||
| Bleeding. | 122 | ||
| Capacity to Tolerate Care. | 122 | ||
| Drug Considerations. | 123 | ||
| Oral Complications and Manifestations | 123 | ||
| Occupational Safety and Health Association | 124 | ||
| References | 124 | ||
| 8 Smoking and Tobacco Use Cessation | 128 | ||
| Epidemiology | 128 | ||
| Pathophysiology and Complications | 128 | ||
| Medical Management | 131 | ||
| Interventions for Smoking Cessation | 131 | ||
| Dental Management | 131 | ||
| Patient Education Literature | 132 | ||
| Counseling | 132 | ||
| Nicotine Replacement Therapy | 132 | ||
| Non–Nicotine Replacement Therapy Pharmacotherapy | 134 | ||
| Oral Manifestations and Complications | 134 | ||
| References | 137 | ||
| 9 Sleep-Related Breathing Disorders | 138 | ||
| Snoring and Obstructive Sleep Apnea | 138 | ||
| Definition | 138 | ||
| Epidemiology | 140 | ||
| Etiology and Pathophysiology | 141 | ||
| Clinical Presentation | 142 | ||
| Signs and Symptoms | 142 | ||
| Laboratory and Diagnostic Findings | 142 | ||
| Medical Management | 144 | ||
| Behavioral Modification | 145 | ||
| Positive Airway Pressure | 145 | ||
| Oral Appliances | 145 | ||
| Surgical Approaches | 147 | ||
| References | 148 | ||
| IV Gastrointestinal Disease | 150 | ||
| 10 Liver Disease | 151 | ||
| Hepatitis | 151 | ||
| General Description | 151 | ||
| Epidemiology | 151 | ||
| Etiology | 152 | ||
| Pathophysiology and Complications | 153 | ||
| Clinical Presentation | 153 | ||
| Laboratory and Diagnostic Findings | 154 | ||
| Medical Management | 154 | ||
| Hepatitis a | 155 | ||
| Epidemiology | 155 | ||
| Pathophysiology and Complications | 155 | ||
| Clinical Presentation | 155 | ||
| Laboratory and Diagnostic Findings | 155 | ||
| Medical Management | 155 | ||
| Hepatitis B | 156 | ||
| Epidemiology | 156 | ||
| Pathophysiology and Complications | 156 | ||
| Clinical Presentation | 157 | ||
| Laboratory and Diagnostic Findings | 157 | ||
| Medical Management | 157 | ||
| Hepatitis C | 158 | ||
| Epidemiology | 158 | ||
| Pathophysiology and Complications | 158 | ||
| Clinical Presentation | 158 | ||
| Laboratory and Diagnostic Findings | 158 | ||
| Medical Management | 159 | ||
| Hepatitis D | 159 | ||
| Epidemiology | 159 | ||
| Pathophysiology and Complications | 160 | ||
| Clinical Presentation | 160 | ||
| Laboratory and Diagnostic Findings | 160 | ||
| Medical Management | 160 | ||
| Hepatitis E | 161 | ||
| Epidemiology | 161 | ||
| Pathophysiology and Complications | 161 | ||
| Clinical Presentation | 161 | ||
| Laboratory and Diagnostic Findings | 161 | ||
| Hepatitis Non–A-E | 162 | ||
| Epidemiology | 162 | ||
| Clinical Presentation | 162 | ||
| Laboratory and Diagnostic Findings | 162 | ||
| Medical Management | 162 | ||
| Pathophysiology and Complications | 162 | ||
| Fulminant Hepatitis. | 162 | ||
| Chronic Infection. | 163 | ||
| Clinical Presentation. | 163 | ||
| Laboratory Findings | 164 | ||
| Aminotransferases. | 164 | ||
| Alkaline Phosphatase. | 164 | ||
| Prevention | 164 | ||
| Prevention Through Active Immunization | 164 | ||
| Prevention Through Passive Immunization | 165 | ||
| Treatment | 165 | ||
| Dental Management | 166 | ||
| Treatment Considerations in Specific Patient Groups | 166 | ||
| Patients With Active Hepatitis. | 166 | ||
| Patients With a History of Hepatitis. | 166 | ||
| Patients at High Risk for Hepatitis B Virus or Hepatitis C Virus Infection. | 166 | ||
| Patients Who Are Hepatitis Carriers. | 167 | ||
| Patients With Signs or Symptoms of Hepatitis. | 167 | ||
| Drug Administration | 168 | ||
| Treatment Planning Modifications | 168 | ||
| Oral Manifestations and Complications. | 168 | ||
| Postexposure Protocols for Health Care Workers | 168 | ||
| Exposure Control Plan | 169 | ||
| Alcoholic Liver Disease | 169 | ||
| Definition | 169 | ||
| Pathophysiology and Complications | 169 | ||
| Clinical Presentation | 171 | ||
| Laboratory Findings | 171 | ||
| Medical Management | 171 | ||
| Dental Management | 172 | ||
| Antibiotics. | 172 | ||
| Bleeding. | 172 | ||
| Capacity to Tolerate Care | 173 | ||
| Drug Considerations. | 173 | ||
| Treatment Planning Modifications. | 173 | ||
| Oral Complications and Manifestations. | 173 | ||
| References | 174 | ||
| 11 Gastrointestinal Disease | 176 | ||
| Peptic Ulcer Disease | 176 | ||
| Epidemiology | 176 | ||
| Etiology | 176 | ||
| Pathophysiology and Complications | 177 | ||
| Clinical Presentation | 179 | ||
| Signs and Symptoms | 179 | ||
| Laboratory and Diagnostic Findings | 179 | ||
| Medical Management | 179 | ||
| Dental Management | 180 | ||
| Identification. | 180 | ||
| Risk Assessment. | 180 | ||
| Recommendations | 181 | ||
| Antibiotics: Infection Risk. | 181 | ||
| Bleeding. | 181 | ||
| Capacity to Tolerate Care. | 181 | ||
| Drug Considerations. | 181 | ||
| Oral Complications and Manifestations | 181 | ||
| Inflammatory Bowel Disease | 183 | ||
| Epidemiology | 183 | ||
| Etiology | 183 | ||
| Pathophysiology and Complications | 183 | ||
| Ulcerative Colitis. | 183 | ||
| V Genitourinary Disease | 192 | ||
| 12 Chronic Kidney Disease and Dialysis | 193 | ||
| Definition | 193 | ||
| Epidemiology | 193 | ||
| Etiology | 194 | ||
| Pathophysiology and Complications | 194 | ||
| Clinical Presentation | 196 | ||
| Signs and Symptoms | 196 | ||
| Laboratory and Diagnostic Findings | 198 | ||
| Medical Management | 198 | ||
| Conservative Care | 198 | ||
| Dialysis | 198 | ||
| Dental Management | 201 | ||
| Patient Under Conservative Care | 201 | ||
| Medical Considerations | 201 | ||
| Identification. | 201 | ||
| Risk Assessment. | 201 | ||
| Recommendations. | 201 | ||
| Antibiotics. | 201 | ||
| Bleeding. | 201 | ||
| Blood Pressure. | 203 | ||
| Capacity to Tolerate Care. | 203 | ||
| Drug Considerations. | 203 | ||
| Oral Complications and Manifestations. | 203 | ||
| Treatment Planning Modifications. | 205 | ||
| Patients Receiving Dialysis | 206 | ||
| Medical Considerations | 206 | ||
| Risk Assessment. | 206 | ||
| Recommendations | 206 | ||
| Antibiotics. | 206 | ||
| Risk of Infection. | 206 | ||
| Bleeding. | 206 | ||
| Blood Pressure. | 207 | ||
| Capacity to Tolerate Care. | 207 | ||
| Drug Considerations. | 207 | ||
| Oral Complications and Manifestations. | 207 | ||
| Patient With Renal Transplant | 207 | ||
| References | 207 | ||
| 13 Sexually Transmitted Diseases | 210 | ||
| Definition | 210 | ||
| Complications | 210 | ||
| Gonorrhea | 210 | ||
| Epidemiology | 211 | ||
| Etiopathogenesis | 211 | ||
| Clinical Presentation | 212 | ||
| Laboratory and Diagnostic Findings | 212 | ||
| Medical Management | 213 | ||
| Dental Considerations | 213 | ||
| Oral Manifestations | 213 | ||
| Syphilis | 213 | ||
| Epidemiology | 213 | ||
| Etiopathogenesis | 213 | ||
| Clinical Presentation | 214 | ||
| Primary Syphilis | 214 | ||
| Secondary Syphilis | 214 | ||
| Latent Syphilis | 215 | ||
| Tertiary Syphilis | 216 | ||
| Congenital Syphilis | 216 | ||
| Laboratory and Diagnostic Findings | 216 | ||
| Nontreponemal Testing | 216 | ||
| Treponemal Testing | 216 | ||
| Medical Management | 217 | ||
| Dental Considerations | 217 | ||
| Oral Manifestations | 217 | ||
| Genital Herpes Simplex Virus Infections | 218 | ||
| Epidemiology | 218 | ||
| Etiopathogenesis | 218 | ||
| Clinical Presentation | 218 | ||
| Primary Infection | 218 | ||
| Recurrent Infection | 219 | ||
| Laboratory and Diagnostic Findings | 219 | ||
| Medical Management | 219 | ||
| Dental Considerations and Oral Manifestations | 220 | ||
| Infectious Mononucleosis | 220 | ||
| Epidemiology | 220 | ||
| Etiopathogenesis | 221 | ||
| Clinical Presentation | 221 | ||
| Laboratory and Diagnostic Findings | 222 | ||
| Medical Management | 222 | ||
| Dental Considerations | 222 | ||
| Oral Manifestations | 222 | ||
| Genital Warts and Human Papillomavirus Infections | 222 | ||
| Epidemiology | 222 | ||
| Etiopathogenesis | 223 | ||
| Clinical Presentation | 223 | ||
| Laboratory and Diagnostic Findings | 223 | ||
| Medical Management | 223 | ||
| Genital Warts | 225 | ||
| Cancer | 225 | ||
| Oral Manifestations and Dental Considerations | 225 | ||
| Summary | 226 | ||
| References | 226 | ||
| VI Endocrine and Metabolic Disease | 229 | ||
| 14 Diabetes Mellitus | 230 | ||
| Definition | 230 | ||
| Epidemiology | 230 | ||
| Etiology | 231 | ||
| Pathophysiology and Complications | 232 | ||
| Clinical Presentation | 235 | ||
| Laboratory and Diagnostic Findings | 235 | ||
| Medical Management | 237 | ||
| Type 1 Diabetes Mellitus | 238 | ||
| General Aspects. | 238 | ||
| Intensive Management. | 238 | ||
| Insulin Preparations. | 238 | ||
| Insulin Regimens. | 239 | ||
| Other Agents That Improve Glucose Control. | 240 | ||
| Type 2 Diabetes Mellitus | 240 | ||
| General Aspects. | 240 | ||
| Glucose-Lowering Agents. | 242 | ||
| Biguanides. | 243 | ||
| Insulin Secretagogues—Agents That Affect the ATP-Sensitive K+ Channel. | 243 | ||
| Insulin Secretagogues—Agents That Enhance GLP-1 Receptor Signaling. | 244 | ||
| α-Glucosidase Inhibitors. | 245 | ||
| Thiazolidinediones. | 245 | ||
| Sodium-Glucose Co-Transporter 2 Inhibitors. | 245 | ||
| Combination Therapy. | 246 | ||
| Emerging Therapies. | 246 | ||
| Insulin Shock | 247 | ||
| Mild Stage. | 247 | ||
| Moderate Stage. | 247 | ||
| Severe Stage. | 247 | ||
| Dental Management | 247 | ||
| Analgesics. | 248 | ||
| Antibiotics. | 248 | ||
| Anesthetics. | 250 | ||
| Complications. | 250 | ||
| Consultation. | 250 | ||
| Diet. | 250 | ||
| Devices. | 251 | ||
| Drugs. | 251 | ||
| Oral Complications and Manifestations | 251 | ||
| References | 252 | ||
| 15 Adrenal Insufficiency | 255 | ||
| Mineralocorticoids | 257 | ||
| Adrenal Androgens | 257 | ||
| Definition | 258 | ||
| Epidemiology | 258 | ||
| Etiology | 258 | ||
| Pathophysiology and Complications | 258 | ||
| Adrenal Crisis | 259 | ||
| Clinical Presentation | 259 | ||
| Signs and Symptoms | 259 | ||
| Hypoadrenalism. | 259 | ||
| Hyperadrenalism. | 260 | ||
| Laboratory and Diagnostic Findings | 260 | ||
| Medical Management | 260 | ||
| Primary Adrenal Insufficiency | 260 | ||
| Secondary Adrenal Insufficiency | 261 | ||
| Tertiary Adrenal Insufficiency | 261 | ||
| Adrenal Crisis | 262 | ||
| Dental Management | 262 | ||
| Identification. | 262 | ||
| Risk Assessment. | 262 | ||
| Recommendations. | 263 | ||
| Hyperadrenalism. | 263 | ||
| Adrenal Insufficiency | 263 | ||
| Antibiotics: Risk of Infection. | 263 | ||
| Bleeding. | 263 | ||
| Blood Pressure. | 263 | ||
| Capacity to Tolerate Care. | 263 | ||
| Drug Considerations and Interactions. | 264 | ||
| Emergency Action. | 265 | ||
| Oral Manifestations | 265 | ||
| References | 265 | ||
| 16 Thyroid Diseases | 268 | ||
| Definition | 268 | ||
| Complications | 268 | ||
| Thyroid Gland | 268 | ||
| Enlargement and Nodules of the Thyroid Gland | 268 | ||
| Function of the Thyroid Gland | 270 | ||
| Epidemiology | 271 | ||
| Etiology | 271 | ||
| Pathophysiology | 272 | ||
| Laboratory and Diagnostic Findings | 272 | ||
| Thyrotoxicosis (Hyperthyroidism) | 273 | ||
| Clinical Presentation | 273 | ||
| Signs and Symptoms. | 273 | ||
| Laboratory Findings | 276 | ||
| Medical Management | 276 | ||
| Management of Thyrotoxic Crisis. | 277 | ||
| Other Causes of Thyrotoxicosis | 277 | ||
| Thyroiditis | 277 | ||
| Clinical Presentation— Hashimoto Thyroiditis | 277 | ||
| Signs and Symptoms | 277 | ||
| Laboratory Findings | 277 | ||
| Medical Management | 278 | ||
| Hypothyroidism | 278 | ||
| Epidemiology | 279 | ||
| Clinical Presentation | 279 | ||
| Signs and Symptoms | 279 | ||
| Medical Management | 279 | ||
| Thyroid Cancer | 280 | ||
| Etiology and Clinical Findings | 280 | ||
| Laboratory and Diagnostic Findings | 281 | ||
| Medical Management | 282 | ||
| Prognosis. | 282 | ||
| Dental Management | 282 | ||
| Medical Considerations | 282 | ||
| Identification. | 282 | ||
| Risk Assessment. | 282 | ||
| Thyrotoxicosis | 282 | ||
| Recommendations | 282 | ||
| Antibiotics and Risk of Infection. | 282 | ||
| Bleeding. | 282 | ||
| Capacity to Tolerate Care. | 282 | ||
| VII Immunologic Disease | 308 | ||
| 18 AIDS, HIV Infection, and Related Conditions | 309 | ||
| Definition | 309 | ||
| Incidence and Prevalence | 309 | ||
| Etiology | 310 | ||
| Pathophysiology and Complications | 314 | ||
| Clinical Presentation | 316 | ||
| Signs and Symptoms | 316 | ||
| Laboratory and Diagnostic Findings | 317 | ||
| Medical Management | 318 | ||
| ART and HAART | 318 | ||
| Chemoprophylaxis | 320 | ||
| Dental Management | 320 | ||
| Treatment Planning Considerations | 321 | ||
| Occupational Exposure to HIV | 322 | ||
| Risk of Transmission From Health Care Personnel | 322 | ||
| Oral Complications and Manifestations | 322 | ||
| References | 328 | ||
| 19 Allergy | 330 | ||
| Epidemiology | 330 | ||
| Etiology | 330 | ||
| Pathophysiology and Complications | 331 | ||
| Humoral Immune System | 331 | ||
| Type I Hypersensitivity. | 331 | ||
| Type II Hypersensitivity. | 333 | ||
| Type III Hypersensitivity. | 333 | ||
| Cellular Immune System | 333 | ||
| Type IV Hypersensitivity. | 333 | ||
| Nonallergic Reactions or Pseudoallergy | 334 | ||
| Laboratory and Diagnostic Findings | 334 | ||
| Medical Management | 334 | ||
| Dental Management | 334 | ||
| Medical Considerations | 334 | ||
| Identification and Risk Assessment. | 334 | ||
| Anesthetics. | 335 | ||
| Antibiotics: Penicillin. | 337 | ||
| Analgesics. | 338 | ||
| Dental Materials and Products | 338 | ||
| Latex Rubber Products. | 339 | ||
| Hereditary Angioedema | 339 | ||
| Other Conditions | 339 | ||
| Treatment Planning Modifications | 339 | ||
| Oral Complications and Manifestations | 339 | ||
| Hypersensitivity | 339 | ||
| Type I Hypersensitivity. | 339 | ||
| Type III Hypersensitivity. | 339 | ||
| Type IV Hypersensitivity. | 340 | ||
| Lichenoid Drug Eruptions | 341 | ||
| Management of Severe Type I Hypersensitivity Reactions | 342 | ||
| Angioedema | 342 | ||
| Anaphylaxis | 343 | ||
| References | 343 | ||
| 20 Rheumatologic Disorders | 345 | ||
| Definition | 345 | ||
| Categories of Rheumatologic Disorders | 345 | ||
| Pathophysiology and Complications | 345 | ||
| Rheumatoid Arthritis | 346 | ||
| Definition | 346 | ||
| Epidemiology | 346 | ||
| Etiology | 346 | ||
| Pathophysiology and Complications | 346 | ||
| Clinical Presentation | 347 | ||
| Laboratory and Diagnostic Findings | 348 | ||
| Medical Management | 348 | ||
| NSAIDs | 349 | ||
| Corticosteroids | 349 | ||
| DMARDs | 349 | ||
| Biologic Agents | 349 | ||
| Janus-Associated Kinase Inhibitors | 351 | ||
| Prosthetic Joints | 351 | ||
| Dental Management | 352 | ||
| Late Prosthetic Joint Infection | 353 | ||
| 2015 Summary of American Dental Association and the American Academy of Orthopedic Surgeons | 353 | ||
| Treatment Planning Modifications | 354 | ||
| Oral Complications and Manifestations | 354 | ||
| Osteoarthritis | 355 | ||
| Definition | 355 | ||
| Etiology | 355 | ||
| Epidemiology | 355 | ||
| Pathophysiology and Complications | 355 | ||
| Clinical Presentation | 356 | ||
| Laboratory and Diagnostic Findings | 356 | ||
| Medical Management | 356 | ||
| Dental Management | 356 | ||
| Oral Complications and Manifestations | 356 | ||
| Systemic Lupus Erythematosus | 357 | ||
| Definition | 357 | ||
| Etiology | 357 | ||
| Epidemiology | 357 | ||
| Pathophysiology and Complications | 357 | ||
| Clinical Presentation | 357 | ||
| Laboratory and Diagnostic Findings | 358 | ||
| Medical Management | 358 | ||
| Dental Management | 358 | ||
| Treatment Planning Considerations | 359 | ||
| Oral Complications and Manifestations | 359 | ||
| Sjögren Syndrome | 359 | ||
| Definition | 359 | ||
| Epidemiology | 360 | ||
| Etiology | 360 | ||
| Pathophysiology and Complications | 360 | ||
| Clinical Presentation | 360 | ||
| Salivary Gland Dysfunction and Hyposalivation | 360 | ||
| Laboratory and Diagnostic Findings | 361 | ||
| Sialometry | 361 | ||
| Dental Management | 361 | ||
| Moisture and Lubrication | 361 | ||
| Oral Complications and Manifestations | 362 | ||
| Prevention and Maintenance | 363 | ||
| Psoriatic Arthritis | 363 | ||
| Definition | 363 | ||
| Epidemiology | 363 | ||
| Pathophysiology and Complications | 363 | ||
| Medical Management | 363 | ||
| VIII Hematologic and Oncologic Disease | 389 | ||
| 22 Disorders of Red Blood Cells | 390 | ||
| Definition | 390 | ||
| Types of Anemia | 390 | ||
| Iron Deficiency Anemia | 390 | ||
| Folate Deficiency Anemia and Pernicious Anemia | 390 | ||
| Hemolytic Anemia | 390 | ||
| Sickle Cell Anemia | 390 | ||
| Glucose-6-Phosphate Dehydrogenase Deficiency | 390 | ||
| Aplastic Anemia | 391 | ||
| Epidemiology | 391 | ||
| Etiology | 391 | ||
| Pathophysiology and Complications | 392 | ||
| Iron Deficiency Anemia | 392 | ||
| Folate Deficiency and Pernicious Anemia | 392 | ||
| Sickle Cell Anemia | 392 | ||
| Clinical Presentation | 392 | ||
| Signs and Symptoms | 392 | ||
| Laboratory and Diagnostic Findings | 393 | ||
| Medical Management | 395 | ||
| Dental Management | 396 | ||
| Medical Considerations | 396 | ||
| Identification and Risk Assessment. | 396 | ||
| Recommendations | 396 | ||
| Anesthesia. | 397 | ||
| Bleeding. | 398 | ||
| Capacity to Tolerate Care. | 398 | ||
| Treatment Planning Modifications | 398 | ||
| Oral Manifestations | 398 | ||
| References | 399 | ||
| 23 Disorders of White Blood Cells | 402 | ||
| Definition | 402 | ||
| Leukocytosis and Leukopenia | 403 | ||
| Cyclic Neutropenia | 403 | ||
| Leukemia and Lymphoma | 403 | ||
| IX Neurologic, Behavioral, and Psychiatric Disorders | 515 | ||
| 27 Neurologic Disorders | 516 | ||
| Stroke (Cerebrovascular Accident) | 516 | ||
| Definition | 516 | ||
| Epidemiology | 516 | ||
| Pathophysiology and Complications | 517 | ||
| Clinical Presentation | 518 | ||
| Laboratory and Diagnostic Findings | 518 | ||
| Medical Management | 518 | ||
| Dental Management | 519 | ||
| Oral Manifestations and Complications | 521 | ||
| Parkinson Disease | 522 | ||
| General Description | 522 | ||
| Epidemiology | 522 | ||
| Pathophysiology and Complications | 522 | ||
| Clinical Presentation | 523 | ||
| Laboratory and Diagnostic Findings | 523 | ||
| Medical Management | 523 | ||
| Dental Management | 524 | ||
| Oral Complications and Manifestations | 526 | ||
| Dementia and Alzheimer Disease | 527 | ||
| General Description | 527 | ||
| Epidemiology | 527 | ||
| Pathophysiology and Complications | 527 | ||
| Clinical Presentation | 527 | ||
| Laboratory and Diagnostic Findings | 528 | ||
| Medical Management | 528 | ||
| Dental Management | 529 | ||
| Oral Complications and Manifestations | 531 | ||
| Epilepsy | 532 | ||
| General Description | 532 | ||
| Epidemiology | 532 | ||
| Pathophysiology and Complications | 533 | ||
| Clinical Presentation | 533 | ||
| Laboratory and Diagnostic Findings | 534 | ||
| Medical Management | 534 | ||
| Dental Management | 535 | ||
| Oral Complications and Manifestations | 537 | ||
| Multiple Sclerosis | 538 | ||
| General Description | 538 | ||
| Epidemiology | 538 | ||
| Pathophysiology and Complications | 538 | ||
| Clinical Presentation | 539 | ||
| Laboratory and Diagnostic Findings | 539 | ||
| Medical Management | 539 | ||
| Dental Management | 540 | ||
| Oral Complications and Manifestations | 540 | ||
| Cerebrospinal Fluid Shunts | 540 | ||
| References | 541 | ||
| 28 Anxiety and Eating Disorders | 544 | ||
| Appendices | 596 | ||
| Appendix A Guide to Management of Common Medical Emergencies in the Dental Office* | 597 | ||
| General Considerations | 597 | ||
| General Principles of Emergency Care | 598 | ||
| Key Points | 598 | ||
| Types of Emergencies and Their Treatment | 598 | ||
| Unconsciousness | 598 | ||
| Syncope and Psychogenic Shock | 598 | ||
| Signs and Symptoms. | 598 | ||
| Cause. | 598 | ||
| Treatment | 598 | ||
| Low Blood Pressure or Slow Pulse | 598 | ||
| Treatment: Low Blood Pressure | 598 | ||
| Treatment: Slow Pulse (Less Than 60 beats/min) | 598 | ||
| Cardiac Arrest | 599 | ||
| Index | 655 | ||
| A | 655 | ||
| B | 657 | ||
| C | 658 | ||
| D | 660 | ||
| E | 661 | ||
| F | 662 | ||
| G | 662 | ||
| H | 663 | ||
| I | 665 | ||
| J | 666 | ||
| K | 666 | ||
| L | 666 | ||
| M | 667 | ||
| N | 668 | ||
| O | 668 | ||
| P | 669 | ||
| Q | 671 | ||
| R | 671 | ||
| S | 672 | ||
| T | 673 | ||
| U | 675 | ||
| V | 675 | ||
| W | 675 | ||
| X | 675 | ||
| Y | 675 | ||
| Z | 675 |