Most mothers do not realize that a dentist must know about the general health of the child
if he has to treat the teeth. This is important for the following reasons:
- Many bodily ailments or infections start or involve the oral
- If your child is under some medication for say, tonsilitis;
the dentist may prescribe similar or conflicting medicines for a tooth infections.
- Most chronic ailments or their long-term treatment have
bearing on dental and oral health of your child.
- A child recovering from say, malaria or jaundice can not be
subjected to operative procedures till he has fully recovered.
Next time round, don't wait for dentist to
ask for relevant medical history, volunteer any positive information you have and you will
see your dentist coming out with a list of questions.
Positive history of the following diseases
should be given, if present. The course of treatment could slightly change if any of these
conditions exist. If any of these conditions are not revealed, they might pose a serious
health hazard. The dental
surgeon should be well prepared to face any emergency.
- Rheumatic Fever / Congenital heart diseases
- Jaundice / Malaria
- Juvenile diabetes
- Haemophilia, Thallasemia, Leukemia, Anemia
- Allergy to any drug
- Emergency treatment should be available during dental
- Patients using inhalers should carry their inhalers with
them to the clinic.
- Inhalation anesthetics/ analgesics (Ibuprofen) should be
avoided as it may precipitate an asthma attack.
Highly infectious disease. In addition to
exposing the dentist and his staff to infection - Dental Treatment has to be deferred till
sputum culture is negative. Special precautions should be used in emergency dental
If your child has suffered from Rheumatic
Fever in the past, he is at a risk of developing bacterial endocarditis after a dental
procedure. If the dentist is aware, he would give a course of preventive antibiotics,
before any procedure that involves gum bleeding e.g. professional cleaning, extraction,
injections etc. Consult your physician/ paediatrician if fever develops within 3 months of
Congenital Heart Disease: Operated or
Same risk of bacterial endocarditis
Yellowish discoloration of sclera (white
portion of the eyeball) nails and even the skin. Liver produces factors, which help in
clotting of blood and also in metabolism of different drugs and anesthetics.
If there is recent history of jaundice no
dental treatment should be carried out. (Procedures, which involve bleeding, use of
injection, local anesthetic and extraction).
Dentist maybe the 1st clinician
to notice leukemia, as active bleeding from the gums is most often the first symptom.
Signs: Enlargement of neck Lymph node
Spontaneous bleeding of gums when platelet count falls below 20,000/mm3
Pale mucosa, smooth shiny tongue
Surgical procedures or periodontal
procedures on patients with severe anemia should be avoided. General anaesthetic should
never be administered.
A haematologist should be considered prior
to dental procedures, which involve bleeding extraction, sealing, root canal
and minor surgery. In these patients painkillers are not to be given. Intra muscular
injections are also avoided. Maintaining healthy gums is very important. Patients
generally ignore oral hygiene, as they are scared that brushing would induce bleeding. The
dental professionals would take care of this by carrying out routine sealing and
In children, when milk teeth are about to
fall, there maybe prolonged oozing of blood from these teeth. Extraction of such teeth is
necessary for control of bleeding.
In these patients it is preferred to carry
out dental procedures like extraction in a hospital where there are facilities for factor
Enlarged, swollen gums are very common in
children with epilepsy taking Phenytoin. Soon after starting anticonvulsant
therapy, you should visit dentist for oral hygiene instruction. Oral hygiene must be
maintained and professional cleaning of teeth should be carried out from time to time.
In today's times it is not unusual to find
children eating pan masala/ guthka (identifying with either parent) or consuming large
quantities of chocolates etc. The dentist must be apprised of such habits.
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