Patient Living with Human Immunodeficiency Virus and Depression with High HIV Viral Load Presenting for Evaluation of Root Caries
A 26-year-old man living with HIV and depression presents with symptoms of tooth sensitivity. His laboratory studies are all within normal limits except for a high viral load. The patient does not require any special dental management protocol and should be treated like other patients, with his laboratory studies reviewed every 6 months to 1 year. HIV is now a chronic medical conditions, with most patients having stable disease if they are compliant with their medications. Universal infection control protocols should be followed for all patients regardless of their HIV status. (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - March 27, 2023 Category: Dentistry Authors: Temitope T. Omolehinwa, Osamudiamen Idahosa, Chizobam Idahosa Source Type: research
Restorative Dental Treatment in a Patient with Mild –Moderate Chronic Kidney Disease (Stages 1–3)
Patients with chronic kidney disease (CKD) stage 2 have mildly damaged kidneys but they still work well. The dentist can proceed with the required restorative dental treatment, which is considered a low-risk non-surgical dental procedure, with no major complications expected. Patients with CKD stage 3 have moderate impairment of renal function with altered drug metabolism, bioavailability, and rate of excretion. Diabetes is a common comorbidity in patients with CKD. (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - March 27, 2023 Category: Dentistry Authors: Dalal Alomar Source Type: research
Patient with Severe End-Stage Renal Disease Stages (4 –5) Presenting for Surgical Periodontal Therapy
Patients with ESRD have an increased risk of bleeding owing to platelet dysfunction associated with uremia. It is important to obtain coagulation tests and complete blood count before the surgical procedure, and abnormal values should be discussed with the patient ’s physician. A conservative surgical technique must be followed to decrease the risk of bleeding and infection. The dentist should ensure the availability of local hemostatic agents at the dental office to be used as needed to obtain hemostasis. Following the medical complexity status (MCS) syste m, the patient can be designated as MCS 2B category. (Source: De...
Source: Dental Clinics of North America - March 27, 2023 Category: Dentistry Authors: Dalal Alomar Source Type: research
Patient on Hemodialysis Develops Painful Periodontal Abscess and Presents for Treatment
Dialysis patients have an increased risk of acquiring hepatitis B, hepatitis C, and HIV because the dialysis machine is disinfected, not sterilized. Therefore, the dentist must follow standard precautions for infection control when treating dialysis patients. Following the medical complexity status (MCS) system, the patient can be designated as MCS 2B category. (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - March 27, 2023 Category: Dentistry Authors: Dalal Alomar Source Type: research
Patient Living with Human Immunodeficiency Virus with a History of Chronic Obstructive Pulmonary Disease and Experiencing Oxygen Desaturation During Dental Treatment
A 60-year-old male patient living with HIV, with a medical history of chronic obstructive pulmonary disease and persistent cough, presents to the dental clinic with rampant caries and multiple missing teeth. He had an average oxygen saturation of 84% observed while taking his vital signs. The authors discuss the management of this patient during routine dental treatment. (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - March 26, 2023 Category: Dentistry Authors: Temitope T. Omolehinwa, Osamudiamen Idahosa, Chizobam Idahosa Source Type: research
Dental Management of the Human Papilloma Virus-Related Oropharyngeal Cancer Patient
Human papilloma virus (HPV)-attributable head and neck cancers (HNCs) are on the rise, impacting younger patients compared with HPV ( −) HNC. Fortunately, HPV (+) HNCs are associated with favorable prognoses and tend to be radiosensitive. However, radiation therapy for the treatment of HNC is associated with acute and chronic normal tissue toxicity to salivary glands, muscles, bone, and the oral cavity and presents a treatment c hallenge. Thus, the prevention of normal tissue injury and optimization of oral health are key. Dental teams are important members of the multidisciplinary cancer team. (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - March 26, 2023 Category: Dentistry Authors: Jillian Rigert, Andres Pinto, Mel Mupparapu Source Type: research
An Adolescent Patient Reports to Dental Office for Pain in Relation to Mandibular Molar with an Incidental Palpable Thrill in the Submandibular Region
A young female patient presents to a dental clinic for treatment of swelling and pain. Clinical examination and testing are completed revealing concomitant, suspected vascular pathology of the head and neck area. An endodontic diagnosis is made, but an unusual clinical finding of a vascular entity, not typically considered by dentists, requires interdisciplinary assessment and management with vascular surgery before surgical intervention of the oral cavity. (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - March 26, 2023 Category: Dentistry Authors: Leonard Jensen, Andres Davila, Andres Pinto, Mel Mupparapu Source Type: research
Patient with Hemophilia A Presenting for Extractions and Implants
The authors describe the management of a 57-year-old man with hemophilia A who presents for extractions and implant placements. The patient required a combination of extractions, scaling and root planning, and composite restorations. The authors describe the management protocol for this patient as well as general considerations in the management of patients with hemophilia A. (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - March 26, 2023 Category: Dentistry Authors: Temitope T. Omolehinwa, Adeyinka Dayo Source Type: research
Dental Extraction in a Patient Living with Human Immunodeficiency Virus with Neutropenia and Thrombocytopenia
A 34-year-old male patient living with human immunodeficiency virus (HIV) presents to the dental clinic with a 1-week history of throbbing tooth pain. He was referred by an oral medicine specialist for evaluation and treatment. The patient presents with very low absolute neutrophil, platelet, and cluster of differentiation (CD) (also T-helper cell) 4+ cell counts, as well as a high HIV RNA/viral load. Determining factors for dental management before extraction of the offending teeth were the absolute neutrophil count and platelet counts. (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - March 26, 2023 Category: Dentistry Authors: Temitope T. Omolehinwa, Osamudiamen Idahosa, Chizobam Idahosa Source Type: research
Patient with von Willebrand Disease Presenting for Selective Scaling and Root Planning
This article discusses the dental management of a 74-year-old white woman presenting with pain and gingival erythema in the maxillary anterior area. The article emphasizes the importance of consultation with the hematologist in treating patients with von Willebrand disease, and understanding that disease severity varies in patients. A patient-specific protocol recommended by the hematologist should be followed for each patient. (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - March 26, 2023 Category: Dentistry Authors: Temitope T. Omolehinwa, Adeyinka Dayo, Enitan Adegite Source Type: research
A 50-Year-Old Woman Living with Human Immunodeficiency Virus and Comorbid Conditions, Presenting for Scaling and Root Planing
This article discusses modifications to her dental management with respect to her various medical conditions. Noninfectious comorbid conditions especially diabetes, cardiovascular disease, and hyperlipidemia are common findings in patients with HIV. Modifications to dental treatment should not be based solely on HIV RNA (viral load) and CD4+ cell count. Dentists can play a role in ensuring patients ’ comorbid medical conditions are well managed. (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - March 26, 2023 Category: Dentistry Authors: Temitope T. Omolehinwa, Osamudiamen Idahosa, Chizobam Idahosa Source Type: research
Patient Living with Humman Immunodeficiency Virus with a History of Chronic Obstructive Pulmonary Disease and Experiencing Oxygen Desaturation During Dental Treatment
A 60-year-old male patient living with HIV, with a medical history of chronic obstructive pulmonary disease and persistent cough, presents to the dental clinic with rampant caries and multiple missing teeth. He had an average oxygen saturation of 84% observed while taking his vital signs. The authors discuss the management of this patient during routine dental treatment. (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - March 26, 2023 Category: Dentistry Authors: Temitope T. Omolehinwa, Osamudiamen Idahosa, Chizobam Idahosa Source Type: research
Patient Living with Human Immunodeficiency Virus with Gingival Pain and Oral Soreness (Red and White Lesions)
A 34-year-old male patient with poorly controlled HIV/AIDS presented with symptoms consistent with oral candidiasis and necrotizing ulcerative gingivitis. He was treated with systemic antifungal agent and topical and systemic antibiotics. (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - March 26, 2023 Category: Dentistry Authors: Temitope T. Omolehinwa, Osamudiamen Idahosa, Chizobam Idahosa Source Type: research
Patient on Hemodialysis with Elevated International Normalized Ratio Presents for Removal of Residual Roots in the Mandible
Dentists should consult the patient ’s nephrologist to obtain the most recent medical records for patients with chronic kidney disease (CKD) including the stage and level of control. Patients on hemodialysis are ideally seen the day after dialysis with consideration to arteriovenous shunt placement for blood pressure measurement and avoiding or changing the dose of certain drugs based on the patient’s glomerular filtration rate. Drugs cleared during hemodialysis may require a supplemental dose. Patients taking oral anticoagulants and requiring oral surgery should have the international normalized ratio (INR) measured t...
Source: Dental Clinics of North America - March 26, 2023 Category: Dentistry Authors: Anwar A. AlMuzaini Source Type: research
Patient with Chronic Liver Disease Was Referred for Evaluation of Oral Infection and Facial Swelling and Needs Multiple Dental Extractions
When a patient with chronic liver disease due to a hepatitis C virus infection presents with a dental emergency, it is important to identify whether the patient is under good medical management, if severe liver dysfunction exists, or if the patient is with active hepatitis. If records are not available, contacting the patient ’s physician to obtain the necessary information is prudent. If the source of infection is odontogenic, extraction should not be delayed. Patients with stable chronic liver disease can safely undergo dental extractions with some modifications to the dental treatment plan. (Source: Dental Clinics of North America)
Source: Dental Clinics of North America - March 26, 2023 Category: Dentistry Authors: Anwar A. AlMuzaini Source Type: research
