Dental Care of the Medically Complex Patient

Edited by:
  • J. Meechan &
  • J. Nunn
, Ed. P.B. Lockhart. London: Elsevier, 2003 price £23.99, pp472 ISBN 0723610908 | ISBN: 0-723-61090-8

This book is a handy-sized reference for dental practitioners who want easily accessible information regarding the relevance of medical conditions to the safe provision of dental treatment. It is written in an easily readable style which may have been enhanced still further by the introduction of some clinical photographs at pertinent points in the text.

The book contains nine chapters that are wide-ranging — from dental emergencies to maxillofacial prosthetics — and are followed by 11 appendices (some less than one page in length) with an equally wide-ranging remit.

Areas of controversy are dealt with authoritatively, eg. the debate for the need or otherwise for supplemental steroids for patients taking or who have taken steroids undergoing certain types of dental treatment. Although pointing out that adrenal crisis in the dental setting is extremely rare it is true that supplementation is often given because it is 'easy, inexpensive and non-threatening to the patient in comparison with the potential outcome from an adrenal crisis'.

Certain areas differ from current UK practice in that the INR considered safe for dental extractions in patients taking warfarin is given as four. Indeed, this is recommended by some authorities, but current advice in the UK is 3.0 (Dental Practitioners' Formulary 2002-4).

Chapter 3 provides a good synopsis of oral medicine and ties in well with the more holistic medical feel of the book overall. The book usefully includes a series of examples of consultation requests and many of the examples will be familiar to readers.

My only criticism of this book is that it perhaps tries to cover too broad a canvas — there are sections detailing subjects such as maxillofacial trauma and topical fluoride concentrations. If the book had been limited strictly to the relevance of medical conditions on dental treatment it might have improved it.

Overall though, this is a very useful book and will be valuable to undergraduate and postgraduate students as well as practising clinicians in both hospital and general practice.