EMPHASIS ON PATIENT MEDICAL HISTORY Dr.Shahzadi Tayyaba Hashmi DNT 356 DENTAL HYGIENE CLINIC II

MEDICAL HISTORY OF THE PATIENT Patient must be asked in a systemic way about all systems e.g Nervous system (migraine, epilepsy, any psychological problem) Respiratory system (asthma,Tuberculosis, respiratory tract problem) Digestive system (indigesion, gastric ulcers) Endocrine system (any problem with the hormones, thyroid gland hormones, diabetes,Cushing syndrome)

MEDICAL HISTORY OF THE PATIENT Patient must be asked about history of excessive bleeding, any experience of allergies or HIV,HBV infection Female patients must be asked about menstruation, pregnancy and menopause Intake of any drug presently or in near past must also be noted Circulatory system (cardiac problem, ischemic heart disease, hypertension) Any muscular, skeletal, reproductive urinary tract or skin problem

IMPORTANCE OF MEDICAL HISTORY IN DENTISTRY Medical history is necessary to avoid emergencies in the office and for the prevention of provoking and dormant disease Premedication or omission of certain drugs may be necessary for some cases Advice of physicians is valuable in patients undergoing /taking medical treatment

MANAGEMENT OF PATIENTS HAVING HEART DISEASE AND THYROID CRISIS Patient with hyperparathyroidism should be dealt with care as they have weak and fragile bones Patient with ischemic heart disease must get clearance from their physician after discussing their intended treatment procedure with the dentist. Adjustment in the medicine is usually necessary during dental treatment Patients having valvular heart disease must be given antibiotic cover before dental treatment to prevent damage caused by bacteria

MANAGEMENT OF PATIENTS HAVING EPILEPSY,ALLERGIES AND ASTHMA Epileptic patients may require increase in their medicine before going for dental treatment Allergies and asthma patients must be dealt with carefully. An allergic patient may take place at any time and dentist should be prepared to deal with the situation

MANAGEMENT OF PATIENTS HAVING HEPATITIS AND BLEEDING DISORDERS Viral Hepatitis patients must be dealt with care as they may be carriers. Immunity of the person in certain cases had been decreased and precautionary measures are necessary (like double masks, double gloves and eye wear) Bleeding disorders must also be considered before starting dental treatment

MANAGEMENT OF A PATIENT HAVING DIABETES AND MENOPAUSE Menopause is associated with oral ulcers. Such patients need symptomatic, supportive therapy along with reassurance Patient must be referred to gynaecologist Diabetes is important to a dentist as well. Deficiency of insulin causes decrease in immunity Antibiotic cover before dental treatment is necessary Care is necessary for patients on insulin therapy Treatment stress causes hypoglycemia. So insulin dose should be omitted prior to dental treatment Dentists must be prepared to deal with hypoglycemic shocks

MANAGEMENT OF A PATIENT HAVING STRESS Physical and psychological stresses are always associated with oral problems Apthous ulcers are a very common complaint in such patients