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Dentist’s Guide
to Medical Conditions
and Complications
Dentist’s Guide to
Medical Conditions
and Complications

Kanchan M. Ganda, M.D.

A John Wiley & Sons, Inc., Publication

Edition first published 2008
© 2008 Wiley-Blackwell

Blackwell Munksgaard, formerly an imprint of Blackwell Publishing was acquired by John Wiley &
Sons in February 2007. Blackwell’s publishing programme has been merged with Wiley’s global
Scientific, Technical, and Medical business to form Wiley-Blackwell.

Editorial Office
2121 State Avenue, Ames, Iowa 50014-8300, USA

For details of our global editorial offices, for customer services and for information about how to
apply for permission to reuse the copyright material in this book please see our website at www.
wiley.com/wiley-blackwell.

Authorization to photocopy items for internal or personal use, or the internal or personal use of
specific clients, is granted by the publisher, provided that the base fee is paid directly to the
Copyright Clearance Center, 222 Rosewood Drive, Danvers, MA 01923. For those organizations that
have been granted a photocopy license by CCC, a separate system of payments has been arranged.
The fee codes for users of the Transactional Reporting Service are ISBN-13: 978-0-8138-0926-7/2008.

Designations used by companies to distinguish their products are often claimed as trademarks. All
brand names and product names used in this book are trade names, service marks, trademarks or
registered trademarks of their respective owners. The publisher is not associated with any product or
vendor mentioned in this book. This publication is designed to provide accurate and authoritative
information in regard to the subject matter covered. It is sold on the understanding that the publisher
is not engaged in rendering professional services. If professional advice or other expert assistance is
required, the services of a competent professional should be sought.

Disclaimer
The contents of this work are intended to further general scientific research, understanding, and
discussion only and are not intended and should not be relied upon as recommending or promoting
a specific method, diagnosis, or treatment by practitioners for any particular patient. The publisher
and the author make no representations or warranties with respect to the accuracy or completeness of
the contents of this work and specifically disclaim all warranties, including without limitation any
implied warranties of fitness for a particular purpose. In view of ongoing research, equipment
modifications, changes in governmental regulations, and the constant flow of information relating to
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Library of Congress Cataloguing-in-Publication Data

Ganda, Kanchan M.
Dentist’s guide to medical conditions and complications / by Kanchan M. Ganda.
p. ; cm.
Includes bibliographical references and index.
ISBN 978-0-8138-0926-7 (alk. paper)
1. Chronically ill—Dental care. 2. Sick—Dental care. 3. Oral manifestations of general
diseases. I. Title.
[DNLM: 1. Stomatognathic Diseases—complications. 2. Dental Care—standards. 3. Medical
History Taking. 4. Pharmaceutical Preparations,
Dental—administration & dosage. 5. Pharmaceutical Preparations,
Dental—contraindications. 6. Stomatognathic Diseases—diagnosis. WU 140 G195d 2008]
RK55.S53G36 2008
617.6’026—dc22
2008007433

A catalogue record for this book is available from the U.S. Library of Congress.

Set in 9.5 on 12 pt Palatino by SNP Best-set Typesetter Ltd., Hong Kong

Printed in Singapore by Markono Print Media Pte Ltd

1 2008
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 Dedication

This book is dedicated to all my students, past and present; to my late parents, Amrit
Devi and Roop Krishan Dewan; and to my family for all their encouragement and
loving support.

v
 Contents

Acknowledgments xii

Introduction: Integration of Medicine in Dentistry xiii

Section I: Patient Assessment 3

1. Routine History-Taking and Physical Examination 5
2. History and Physical Assessment of the Medically
Compromised Dental Patient (MCP) 25

Section II: Pharmacology 31

3. Prescription Writing, DEA Schedules, and FDA
Pregnancy Drug Categories 33
4. Local Anesthetics Commonly Used in Dentistry: Assessment,
Analysis and Associated Dental Management Guidelines 40
5. Analgesics Commonly Used in Dentistry: Assessment,
Analysis, and Associated Dental Management Guidelines 48
6. Odontogenic Infections and Antibiotics Commonly Used
in Dentistry: Assessment, Analysis, and Associated Dental
Management Guidelines 63
7. Antifungals Commonly Used in Dentistry: Assessment,
Analysis, and Associated Dental Management Guidelines 83
8. Antivirals Commonly Used in Dentistry: Assessment,
Analysis, and Associated Dental Management Guidelines 87

Section III: Acute Care and Stress Management 91

9. Management of Medical Emergencies in the Dental Setting:
Assessment, Analysis, and Associated Dental Management
Guidelines 93

vii
viii Contents

10. Oral and Parenteral Conscious Sedation for Dentistry: Assessment,

Analysis, and Associated Dental Management Guidelines 110

Section IV: Hematopoietic System 125

11. Complete Blood Count (CBC): Assessment, Analysis, and Dental
Management Guidelines 127
12. Red Blood Cells (RBCs) Associated Disorder: Anemia:
Assessment, Analysis, and Associated Dental
Management Guidelines 134
13. Red Blood Cells Associated Disorder: Polycythemia: Assessment,
Analysis, and Associated Dental Management Guidelines 144
14. Red Blood Cells Associated Disorder: Hemochromatosis:
Assessment, Analysis, and Associated Dental
Management Guidelines 146

Section V: Hemostasis and Associated Bleeding Disorders 149

15. Primary and Secondary Hemostasis: Normal Mechanism,
Disease States, and Coagulation Tests: Assessment,
Analysis, and Associated Dental Management Guidelines 151
16. Platelet Disorders: Thrombocytopenia, Platelet Dysfunction, and
Thrombocytosis: Assessment, Analysis, and Associated Dental
Management Guidelines 155
17. Von Willebrand’s Disease: Assessment, Analysis, and Associated
Dental Management Guidelines 159
18. Coagulation Disorders: Common Clotting Factor Deficiency
Disease States, Associated Systemic and/or Local Hemostasis
Adjuncts, and Dental Management Guidelines 162
19. Anticoagulants Warfarin (Coumadin), Standard Heparin,
and Low Molecular Weight Heparin (LMWH): Assessment,
Analysis, and Associated Dental Management Guidelines 169

Section VI: Cardiology 175

20. Rheumatic fever (RF): Assessment, Analysis, and Associated
Dental Management Guidelines 177
21. Infective Endocarditis and Current Premedication Prophylaxis
Guidelines 181
22. Hypertension and Target Organ Disease States: Assessment,
Analysis, and Associated Dental Management Guidelines 189
23. Cerebral Circulation Diseases TIAs and CVAs: Assessment,
Analysis, and Associated Dental Management Guidelines 195
 Contents ix

24. Coronary Circulation Diseases, Classic Angina and

Myocardial Infarction: Assessment, Analysis, and Associated
Dental Management Guidelines 197
25. Congestive Heart Failure (CHF): Assessment, Analysis, and
Associated Dental Management Guidelines 202
26. Cardiac Arrhythmias: Assessment, Analysis, and Associated
Dental Management Guidelines 204
27. Peripheral Circulation Disease 206
28. Renal Function Tests, Renal Disease, and Dialysis:
Assessment, Analysis, and Associated Dental
Management Guidelines 207

Section VII: Pulmonary Diseases 213

29. Pulmonary Function Tests and Sedation with
Pulmonary Diseases: Assessment, Analysis, and Associated
Dental Management Guidelines 215
30. Upper Airway Disease: Assessment, Analysis, and Associated
Dental Management Guidelines 218
31. Asthma and Airway Emergencies: Assessment,
Analysis, and Associated Dental Management Guidelines 220
32. Chronic Bronchitis: Assessment, Analysis, and Associated
Dental Management Guidelines 226
33. Emphysema: Assessment, Analysis, and Associated
Dental Management Guidelines 227
34. Chronic Obstructive Pulmonary Disease (COPD):
Assessment, Analysis, and Associated Dental
Management Guidelines 228
35. Obstructive Sleep Apnea (OSA): Assessment, Analysis, and
Associated Dental Management Guidelines 232
36. Tuberculosis: Assessment, Analysis, and Associated
Dental Management Guidelines 233

Section VIII: Clinical Pharmacology 239

37. Prescribed and Nonprescribed/Over-the-Counter Medications:
Assessment, Analysis, and Associated Dental Management
Guidelines 241

Section IX: Endocrinology 245

38. Diabetes: Type 1 and Type 2 Diabetes: Assessment, Analysis, and
Associated Dental Management Guidelines 247
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