Practice abstract
British Dental Journal 195, 181 - 184 (2003)
Published online: 23 August 2003 | doi:10.1038/sj.bdj.4810434
Verifiable CPD Paper:
General medicine and surgery for dental practitioners Part 7: Renal disorders
M Greenwood1, J G Meechan2 & D G Bryant3
- Renal patients may have impaired drug excretion. Drugs used in dental sedation and general anaesthesia should be used with caution and in consultation with a physician.
- Renal disease influences the use of other drugs in dentistry, particularly NSAIDS and some antimicrobials
- Platelet dysfunction may occur in renal patients giving rise to a bleeding tendency. Patients on haemodialysis may be heparinised. Dental treatment should be carried out on the day after dialysis. Renal condition is optimal at this time and the anticoagulant effect has stopped.
- The arm with vascular access for dialysis (the surgically created arterio-venous fistula) should not be used for venepuncture by the dentist.
- Patients who have had a kidney transplant may need corticosteroid cover, have a bleeding tendency if anticoagulated, may have gingival hyperplasia if taking ciclosporin and are prone to infection due to immunosuppression.
General medicine and surgery for dental practitioners:
- Cardiovascular system
- Respiratory system
- Gastrointestinal system
- Neurological disorders
- Liver disease
- The endocrine system
- Renal disorders
- Musculoskeletal system
- Haematology and patients with bleeding problems
- The paediatric patient
Abstract
Patients with kidney disorders are increasingly encountered in dental practice due to improvements in medical care leading to prolonged life expectancy. In order to provide appropriate and safe dental care for these patients it is important to have a working knowledge of renal disorders and related problems.
- Lecturer, Department of Oral and Maxillofacial Surgery, The Dental School, Framlington Place, Newcastle upon Tyne NE 4BW
- Senior Lecturer, Department of Oral and Maxillofacial Surgery, The Dental School, Framlington Place, Newcastle upon Tyne NE 4BW
- Specialist Registrar, Department of Oral & Maxillofacial Surgery, Middlesbrough General Hospital
Correspondence to: M Greenwood1 e-mail: beryl.leggatt@ncl.ac.uk