pt managment

Question 1

What lab tests are used to assess diabetes control?

Answer 1

Fasting plasma glucose: 70-100 mg/dL (normal)
Nonfasting plasma glucose: 140-200 mg/dL (normal)
HbA1c: 4-6% (normal)

Question 2

What are key recommendations to reduce the risk of hypoglycemia during dental visits?

Answer 2

Morning appointments preferred
Normal meal intake before the visit
Treatment breaks and snacks if needed
Avoid peak insulin activity

Question 3

What lab test should be performed before dental treatment for patients on anticoagulants?

Answer 3

INR within 48 hours (Therapeutic range: <3 is safe for treatment).

Question 4

What should be done if a patient is taking Coumadin (warfarin)?

Answer 4

May need to discontinue 2-3 days before surgery (consult physician).
Some patients may require Heparin injections as a bridge.

Question 5

Which medications should be avoided for patients on anticoagulants?

Answer 5

Aspirin and NSAIDs

Question 6

Name some dental procedures that can cause significant bacteremia.

Answer 6

Extractions
Implant placement
Tooth reimplantation
Periodontal surgery, SRP, and probing
Endodontic surgery beyond the root apex
Intraligamentary injections
Placement of subgingival antibiotic fibers

Question 7

Is there a proven link between dental procedures and prosthetic joint infections?

Answer 7

No proven link exists.

Question 8

Who should prescribe antibiotics if an orthopedic surgeon recommends them against the dentist’s judgment?

Answer 8

The orthopedic surgeon should prescribe them.

Question 9

When should antibiotic prophylaxis be considered for patients with joint replacements?

Answer 9

If the patient is immunocompromised
Poor glycemic control
History of deep prosthetic joint infection
If recommended by an orthopedic surgeon

Question 10

What conditions require antibiotic prophylaxis before dental procedures?

Answer 10

Artificial heart valves
History of infective endocarditis
Cardiac transplant with valve regurgitation
Certain congenital heart diseases (cyanotic or prosthetic repair)

Question 11

What is the standard oral antibiotic and dose for infective endocarditis prevention?

Answer 11

Amoxicillin 2g (single dose 30-60 min before procedure).

Question 12

What antibiotics can be given if the patient is unable to take oral medication?

Answer 12

Ampicillin (IV/IM) 2g
Cefazolin or Ceftriaxone (IV/IM) 1g

Question 13

What antibiotics can be given for penicillin-allergic patients?

Answer 13

Cephalexin 2g (oral)
Azithromycin or Clarithromycin 500mg (oral)

Question 14

What antibiotics can be given for penicillin-allergic patients who can’t take oral meds?

Answer 14

Cefazolin or Ceftriaxone (IV/IM) 1g