Risk Assessment Flashcards
Why is a risk assessment necessary?
- Identify patients at increased medical risk
- Prevent medical emergencies
- Plan dental treatment appropriately
- Ensure interdisciplinary care coordination
What are the goals of a risk assessment?
To determine whether dental treatment is safe to proceed, requires modifications, should be deferred
- reduce morbidity and mortality
- individualize patient care
- establish legal documentation
What are components of a risk assessment?
- Medical History Review
- Physical Examination
- Functional Capacity Assessment
What are issues/factors of concern A–F?
Analgesics
Antibiotics
Anesthesia
Anxiety
Bleeding
Breathing
Blood pressure
Capacity to tolerate care
Drugs
Devices
Equipment
Emergencies
Follow-up
What considerations should be made regarding analgesics in medically compromised patients?
- Is the patient taking aspirin or other NSAIDs that may increase bleeding time?
- Will analgesics be needed after the procedure?
What factors should be assessed before prescribing antibiotics to dental patients?
◦ Will the patient need antibiotics, either prophylactically or therapeutically?
◦ Is the patient currently taking an antibiotic?
What should be considered with anesthesia in patients with medical conditions?
Are there any potential problems or concerns associated with the use of local anesthetic and/or with vasoconstrictors?
what should be considered in a patient with Allergies?
- Does the patient have an allergy to substances or drugs that may be used or prescribed?
- What was the reaction?
what should be considered in a patient with Anxiety?
will the patient need a sedative or anxiolytic
What are the key components of the General Stress Reduction Protocol in dental care?
- Open communication about fears or concerns
- Short, preferably morning appointments
- Preoperative sedation with short-acting benzodiazepines
- Intraoperative sedation with nitrous oxide–oxygen (N₂O–O₂)
- Profound local anesthesia (use topical before injection)
- Adequate postoperative pain control
- Patient contacted on the evening of the procedure
what should be considered in patients relating to bleeding?
Is abnormal hemostasis a possibility from medical condition of medications?
what should be considered in patients relating to breathing?
Does the patient have any difficulty breathing, or is the breathing abnormally fast or slow?
what should be considered in patients relating to blood pressure?
Is the blood pressure well controlled, or is it likely to increase or decrease during dental treatment?
what are the potiental issues or concernds for chaier position and capacity for toleration?
- can they handle supine chair position
- can they handle rapid position change
- can they engage in normal physical activity
- shortness of breathe when walking up stairs?
Why is it important to assess drug use in risk assessment?
to determine if drug interactions, adverse effects, or allergies been associated with any of the drugs being taken by the patient or with drugs that the dentist may use or prescribe
what are the prosthetic or therapeutic devices that may require specific considerations in management?
◦ Prosthetic heart valve
◦ Prosthetic joint
◦ Stent
◦ Pacemaker
◦ Defibrillator
◦ Arteriovenous fistula
