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.

1. Asthma
2. Tuberculosis
3. Rheumatic Fever / Congenital heart diseases
4. Jaundice / Malaria
5. Juvenile diabetes
6. Haemophilia, Thallasemia, Leukemia, Anemia
7. HIV
8. Allergy to any drug
9. Epilepsy

1. Emergency treatment should be available during dental procedures
2. Patients using inhalers should carry their inhalers with them to the clinic.
3. Inhalation anesthetics/ analgesics (Ibuprofen) should be avoided as it may precipitate an asthma attack.

Tuberculosis:

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 treatment.

Rheumatic Fever:

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 dental Treatment.

Congenital Heart Disease: Operated or otherwise

Same risk of bacterial endocarditis

Jaundice:

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).

Leukemia:

Dentist maybe the 1^st clinician to notice leukemia, as active bleeding from the gums is most often the first symptom.

Signs: Enlargement of neck Lymph node
Oral Bleeding
Gum Enlargement
Oral infection
Spontaneous bleeding of gums when platelet count falls below 20,000/mm³

Anemia:

Pale mucosa, smooth shiny tongue

Surgical procedures or periodontal procedures on patients with severe anemia should be avoided. General anaesthetic should never be administered.

Haemophilia:

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 polishing.

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 replacement.

Epilepsy:

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.

Habits:

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.