Author Information

Kanchan Ganda, MD, is the Director of Medicine at Tufts Dental School and is responsible for the creation, implementation and co-ordination of teaching dental students. Additionally, she acts as Medical Consultant for all medically complex patients seen in the Tufts Dental Clinics. She also oversees the prevention and care of medical emergencies and personally lectures in continuing education courses to faculty and outside practitioners.

Table of Contents

Acknowledgments xii

Introduction: Integration of Medicine in Dentistry xiv

Section I: Patient Assessment 1

1. Routine History-Taking and Physical Examination 3
2. History and Physical Assessment of the Medically Complex Dental Patient 24

Section II: Pharmacology 33

3. Essentials in Pharmacology: Drug Metabolism, Cytochrome P450 Enzyme System, and Prescription Writing 35
4. Local Anesthetics Commonly Used in Dentistry: Assessment, Analysis, and Associated Dental Management Guidelines 54
5. Pain Physiology, Analgesics, Opioid Dependency Maintenance Therapies, Multimodal Analgesia, and Pain Management Algorithms 67
6. Odontogenic Infections, Antibiotics, and Infection Management Protocols 110
7. Antifungals Commonly Used in Dentistry: Assessment, Analysis, and Associated Dental Management Guidelines 150
8. Antivirals Commonly Used in Dentistry: Assessment, Analysis, and Associated Dental Management Guidelines 155

Section III: Acute Care and Stress Management 159

9. Management of Medical Emergencies: Assessment, Analysis, and Associated Dental Management Guidelines 161
10. Oral and Parenteral Conscious Sedation for Dentistry: Assessment, Analysis, and Associated Dental Management Guidelines 183

Section IV: Hematopoietic System 199

11. Complete Blood Count: Assessment, Analysis, and Associated Dental Management Guidelines 201
12. Red Blood Cells Associated Disorder: Anemia: Assessment, Analysis, and Associated Dental Management Guidelines 209
13. Red Blood Cells Associated Disorder: Polycythemia: Assessment, Analysis, and Associated Dental Management Guidelines 222
14. Red Blood Cells Associated Disorder: Hemochromatosis: Assessment, Analysis, and Associated Dental Management Guidelines 225

Section V: Hemostasis and Associated Bleeding Disorders 229

15. Primary and Secondary Hemostasis: Normal Mechanisms, Disease States, and Coagulation Tests: Assessment, Analysis, and Associated Dental Management Guidelines 231
16. Platelet Disorders: Thrombocytopenia, Platelet Dysfunction, and Thrombocytosis: Assessment, Analysis, and Associated Dental Management Guidelines 243
17. VonWillebrand’s Disease: Assessment, Analysis, and Associated Dental Management Guidelines 250
18. Coagulation Disorders: Common Clotting Factor Deficiency Disease States, Associated Systemic and/or Local Hemostasis Adjuncts, and Dental Management Guidelines 254
19. Anticoagulants: Assessment, Analysis, and Associated Dental Management Guidelines 262

Section VI: Cardiology and Renal Disease 273

20. Rheumatic Fever: Assessment, Analysis, and Associated Dental Management Guidelines 275
21. Infective Endocarditis and Current Premedication Prophylaxis Guidelines 279
22. Hypertension and Target Organ Disease States: Assessment, Analysis, and Associated Dental Management Guidelines 288
23. Cerebral Circulation Diseases TIAs and CVAs: Assessment, Analysis, and Associated Dental Management Guidelines 300
24. Coronary Circulation Diseases, Classic Angina, and Myocardial Infarction: Assessment, Analysis, and Associated Dental Management Guidelines 302
25. Congestive Heart Failure: Assessment, Analysis, and Associated Dental Management Guidelines 311
26. Cardiac Arrhythmias: Assessment, Analysis, and Associated Dental Management Guidelines 315
27. Peripheral Circulation Disease 318
28. Renal Function Tests, Renal Disease, and Dialysis: Assessment, Analysis, and Associated Dental Management Guidelines 319

Section VII: Pulmonary Diseases 331

29. Pulmonary Function Tests and Sedation with Pulmonary Diseases: Assessment, Analysis, and Associated Dental Management Guidelines 333
30. Upper Airway Disease: Allergic Rhinitis, Sinusitis, and Streptococcal Pharyngitis: Assessment, Analysis, and Associated Dental Management Guidelines 337
31. Asthma and Airway Emergencies: Assessment, Analysis, and Associated Dental Management Guidelines 341
32. Chronic Bronchitis and Smoking Cessation 348
33. Emphysema: Assessment, Analysis, and Associated Dental Management Guidelines 356
34. Chronic Obstructive Pulmonary Disease: Assessment, Analysis, and Associated Dental Management Guidelines 358
35. Obstructive Sleep Apnea: Assessment, Analysis, and Associated Dental Management Guidelines 365
36. Tuberculosis: Assessment, Analysis, and Associated Dental Management Guidelines 367

Section VIII: Clinical Pharmacology 375

37. Prescribed and Nonprescribed Medications: Assessment, Analysis, and Associated Dental Management Guidelines 377

Section IX: Endocrinology 383

38. Introduction to Endocrinology and Diabetes: Assessment, Analysis, and Associated Dental Management Guidelines 385
39. Thyroid Gland Dysfunctions: Assessment, Analysis, and Associated Dental Management Guidelines 403
40. Adrenal Gland Disease States: Assessment, Analysis, and Associated Dental Management Guidelines 408
41. Parathyroid Dysfunction Disease States: Assessment, Analysis, and Associated Dental Management Guidelines 417
42. Growth Hormone Dysfunction and Endocrine Tissues of the Reproductive System 433

Section X: Seizure Disorders 437

43. Classic Seizures: Assessment, Analysis, and Associated Dental Management Guidelines 439

Section XI: Gastrointestinal Conditions and Diseases 447

44. Gastrointestinal Disease States and Associated Oral Cavity Lesions: Assessment, Analysis, and Associated Dental Management Guidelines 449

Section XII: Hepatology 465

45. Liver Function Tests, Hepatitis, and Cirrhosis: Assessment, Analysis, and Associated Dental Management Guidelines 467

Section XIII: Postexposure Prevention and Prophylaxis 493

46. Needle-Stick Exposure Protocol and CDC Recommendations for Dental Health-Care Providers Infected with the Hepatitis B Virus 495

Section XIV: Infectious Diseases 503

47. Human Immunodeficiency Virus, Herpes Simplex and Zoster, Lyme Disease, MRSA Infection, and Sexually Transmitted Diseases 505

Section XV: Oral Lesions and Dentistry 539

48. Therapeutic Management of Oral Lesions in the Immune-Competent and the Immune-Compromised Patient in the Dental Setting 541

Section XVI: The Female Patient: Pregnancy, Lactation, and Contraception 565

49. Pregnancy, Lactation, and Contraception: Assessment and Associated Dental Management Guidelines 567

Section XVII: Rheumatology: Diseases of the Joints, Bones, and Muscles 587

50. Classic Rheumatic Diseases: Assessment and Associated Dental Management Guidelines 589

Section XVIII: Oncology: Head and Neck Cancers, Leukemias, Lymphomas, and Multiple Myeloma 625

51. Head and Neck Cancers and Associated Dental Management Guidelines 627

Section XIX: Psychiatry 661

52. Psychiatric Conditions: Assessment of Disease States and Associated Dental Management Guidelines 663

Section XX: Transplants 683

53. Organ Transplants, Immunosuppressive Drugs, and Associated Dental Management Guidelines 685

Section XXI: Common Laboratory Tests 695

54. Comprehensive Metabolic Panel and Common Hematological Tests 697

Appendix: Suggested Reading 699

Index 743