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Medical conditions and oral health

Will I need to tell my dentist if I have a medical condition?

When you have your first dental check-up, your dental team will want to know about your medical history. You will need to tell them about any medical conditions, recent operations, allergies, and about any tablets or medicines you are taking that may affect your dental treatment.

You may think that some conditions are not important enough to mention. However, quite often these conditions are just as important. The information will help your dentist and the dental team work together to make sure they treat you in the safest way possible and do not put you at any risk during treatment.

Is this information confidential?

Yes. The dental team will keep this information confidential.

What if I am taking any medicines?

You will need to tell your dental team if you are taking, or rely on, any medicines. This should include any inhalers, a recent course of antibiotics or regular medication for a condition you have. You need to tell them if you have had a recent prescription from your doctor and whether you take recreational drugs. It is also important to remember to tell your dental team if you have taken any medicines or tablets recently that you have bought from the pharmacist without a prescription.

Tell your dental team if you are taking an oral contraceptive pill. This is in case you need a course of antibiotics. These can cause the pill to be less effective, and you will need to use other forms of contraception as well.

Will my dental team contact my doctor?

They may do. But they should always ask your permission first. Sometimes, especially for difficult dental procedures or extractions, the dental team may want to contact your doctor for advice. If you have had a recent operation, or rely on medication, your dental team may ask your doctor if there are any problems which may affect your dental treatment.

How often should I visit my dentist?

Visit your dental team regularly, as often as they recommend. If you have certain medical conditions your dental team may want to see you more often. Patients who have ‘dry mouth' caused by medication may be more likely to get tooth decay and will need checking more often.

You may also need regular ‘scale and polish' appointments to keep up your good dental health.

Will I need to be treated in hospital?

In some situations you may need to be seen by a specialist dental team at your local hospital or medical centre to make sure you get the best care. This is especially likely if you have a blood disorder, a heart complaint or severe asthma. The staff will be specially trained to deal with patients who have medical conditions, and the necessary back-up is there if it is needed.

Will I need a general anaesthetic?

Not always. General anaesthetics are not widely used nowadays, and a local anaesthetic is the safest option. Patients with heart complaints and severe asthma for example may find they are unsuitable for a general anaesthetic, and therefore would have to look at alternatives.

Are there any medical conditions that could affect my mouth?

Some medical conditions which need regular medication can mean you are more likely to get ‘dry mouth'. This in turn can cause tooth decay.

If you have epilepsy and rely on sodium valproate, always ask for a sugar-free product if you need the drug in syrup or liquid form. Phenytoin, another drug prescribed for epilepsy, can cause gum problems.

What other medicines cause a dry mouth?

Dry mouth can be caused by radiation treatment to the head and neck, damage to the salivary glands or by certain drugs. Antispasmodics, tricyclic antidepressants, some anti-psychotic drugs and HAART (Highly Active Anti-Retroviral Therapy - for people living with HIV) can all cause dry mouth.

There are many artificial saliva products, sprays and lozenges that your dentist can prescribe. These may help to ease your symptoms. The reduced saliva flow can increase the chance of tooth decay. It is important to brush last thing at night and at least one other time during the day, with a fluoride toothpaste. Have sugary foods and drinks just at mealtimes.

What might happen if I have a heart complaint, a heart murmur or rheumatic fever?

Always make sure your dental team know about your medical condition. People with these conditions used to be given an antibiotic before some dental treatments, but this is no longer considered to be necessary.

The dental team may choose to use a different kind of local anaesthetic (one without adrenalin).

Is there a link between gum problems and heart disease?

Recent scientific research has shown a link between poor oral health and some health conditions - especially between gum disease and conditions such as diabetes, heart and lung disease and poor pregnancy outcomes. This highlights the importance of good dental care.

Keeping to a good oral hygiene routine at home and visiting your dental team regularly will help to prevent gum disease. This will help you avoid the risk of other problems.

How can my dentist help if I have asthma?

If you have asthma, make sure you tell your dental team. If you have an inhaler, it is important to take it to every dental appointment. Always tell your dental team if you feel unwell or out of breath. If you have severe asthma, general anaesthetics or sedation may not be suitable for you. So the safest option would be a local anaesthetic.

What if I am taking warfarin?

It is important to tell your dental team if you are taking warfarin, before you have any treatment - especially if you need to have a tooth out. You may need to have routine blood tests before starting treatment to make sure your blood will clot enough to stop any bleeding.

Your dental team may suggest stopping your warfarin for 2 to 3 days before you have your tooth out. However, some patients don't need to alter their medication and there should be no risk of complications afterwards. Your dental team will be able to tell you more, and may contact your doctor for advice before starting the treatment.

Should I tell my dentist if I am taking anti-depressant drugs?

Yes. It is important to tell your dental team if you are taking any of these medicines. The local anaesthetic may interfere with tricylic anti-depressants, so the dental team may recommend a different anaesthetic.

A side effect of some anti-depressant drugs is ‘dry mouth'. Your mouth makes less saliva, which can mean you have more chance of tooth decay and gum disease.

What will happen if I have haemophilia?

Haemophilia is a blood disorder which means your blood does not clot. You must tell your dental team at your first check-up if you have this condition.

If your blood does not clot it may cause serious problems during dental treatment. If you need to have a tooth out, the dentist will need to refer you to the local hospital to be treated by a specialist. After you have had a tooth out, a clot needs to form in the socket to help it heal.

Many patients take tablets for haemophilia and it is important to tell your dental team if you are on any medication.

I have anaemia, can this affect my dental health?

If you have anaemia you may get more mouth ulcers. You may also get red lines and patches on your tongue. Ulcers usually last 7 to 10 days. However, if you keep getting ulcers they may take up to six weeks to heal. If you have an ulcer that does not heal within 3 weeks, ask your dentist to check it. There are various sprays and creams that your dentist can prescribe if your symptoms continue.

Why might I be tested for sickle cell anaemia?

Sickle cell disease is a form of anaemia which affects people of African and Caribbean origin. If you are in this ethnic group and need a general anaesthetic, you will have blood tests to make sure this is safe for you.

Can a dentist refuse to treat me if I have HIV or hepatitis?

A dentist should not refuse to treat you if you have HIV or hepatitis.

Because of the risk of blood-borne infections, all dental practices have to follow very strict policies to prevent infections being passed on. Many dental instruments are disposable and will be used only once, and all other equipment will be sterilised before being used again.Because of the risk of blood-borne infections, all dental practices have to follow very strict policies to prevent infections being passed on. Many dental instruments are disposable and will be used only once, and all other equipment will be sterilised before being used again.

Will HIV affect my oral health?

It is important to establish a very thorough oral hygiene routine as early as possible and to see your dental team as often as they recommend.

Problems with the inside of your mouth are only common in uncontrolled HIV. Lesions can appear, which may be purple-red discolourations or larger growths. Oral thrush is also common when the immune system has failed, but can be quickly treated by medication. ‘Hairy leukoplakia' is a common oral condition and appears as white lesions on the tongue - it can often be the first sign of HIV.

Gum disease is common with HIV, and often develops very quickly when the condition is uncontrolled. Because the immune system is weakened, the gum disease is more severe and people often have to take antibiotics.

‘Dry mouth' is another side effect of HIV and can cause tooth decay because of the reduced levels of saliva. Your oral care routine should include using a fluoride toothpaste and you may need fluoride supplements too. You can be prescribed sprays or lozenges to ease your discomfort. It is important to always ask for sugar-free products.

Will diabetes affect my teeth and gums?

People who have diabetes can have severe gum disease if their condition is uncontrolled. So it is important to keep to a thorough oral care routine at home and to visit your dental team regularly, as often as they recommend. You may also find that you heal more slowly after surgery, and you should discuss this with your dental team before you have any treatment.

Will epilepsy interfere with my dental treatment?

It is important to tell your dental team if you have epilepsy, or have ever had any sort of fit in the past. This is to make sure the dental team are fully prepared if you become ill during treatment, and can have drugs ready if they are needed.

Patients with epilepsy may be more likely to have fits when they are anxious. Tell your dental team before or during your treatment if you have any concerns. The dental team will make sure the surgery is safe for you and there is no risk of harm to you.

How can my dental team help if I have diabetes?How can my dental team help if I have diabetes?

Book your appointments at a time when the dental team is least likely to keep you waiting: for example, first thing in the morning. Try to avoid lunchtime in case you have to miss a meal.

Will chemotherapy affect my dental treatment?

If you are going to have a course of chemotherapy, visit your dental team as soon as possible to make sure any dental treatment you need is finished before you start.

Chemotherapy can cause gum ulcers or the gums to bleed. Regular appointments with the dental team should help to keep this under control. The team will also tell you if you are brushing correctly and will check that you are keeping up a good oral hygiene routine at home.

Some cancer patients find that chemotherapy causes a sore throat, difficulty in swallowing, and in some cases a partial or complete loss of taste.

Radiation therapy can often cause damage to the salivary glands, leading to a permanently dry mouth. Because your mouth produces less saliva, there is more risk of tooth decay so it is important to have regular dental check-ups.