Systemic Implications in Dental practice

Cyclosporine therapy may cause gingival hyperplasia

Gingival growth occurs in patients taking phenytoin.

Patients with cardiac disease should receive dental treatment in minimal stressful environment. Anxiety,exertion and pain should be minimized.

Irregular pulse, engorged jugular veins and tachypnea may indicate the presence of cardiac disease.A history of hypertension, ischemic heart disease or any other cardiac problem particularly congenital heart disease and drug intake (anticoagulant, aspirin) should be sought.Angina may present as pain in the mandible, teeth and other oral Tissues Epinephrine in the local anesthesia may raise the blood pressure and precipitate dysarrhythmias.In patients with IHD, facilities for medical help, oxygen and nitroglycerine should be Available General anesthesia should be avoided for at least three months in patients with recent onset angina

Patient’s with Cushing’s syndrome more prone to get infections.(candidiasis)

Elective dental surgery should be deferred for 6 months following acute MI.Prophylaxis for infective endocarditis is mandatory in cases where there is a risk.Cardiac patients on anticoagulant drugs or aspirin are at increased risk of bleeding following dental procedures.Hence, these drugs should preferably be stopped a week before the procedure.Calcium channel blockers may cause gingival swelling and lichenoid lesions in the oral cavity. ACE inhibitorscan cause loss of taste, burning sensation in oral cavity,and angioedema. Dry mouth can result due toantihypertensive drugs such as d

Rifampicin can cause red saliva.

Elective dental care is avoided in patients with acuterenal failure

Elective dental procedures are better tolerated on non-dialysis days

Blood pressure measurement is advised at every visit.

Brown to black macular pigmentation in oral mucosa can be suspected for Addison disease.

Gonorrhea may present uncommonly with oral manifestations like tonsillitis, lymphadenitis, and painful oral and pharyngeal ulcers.

Oral manifestations in peptic ulcer disease are rare.However erosive dental lesions could be appreciated on lingual surface of lower incisors or palatal surface of upper maxillary teeth.

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