Special Patient DH 152

Tang Blanton
Hillary Reed
Justine Mcleod
Kalyn Burrows
Personal History

65 year old
Caucasian
Male
Retired Military
Medical History
Type 2 Diabetes

Hypertension

Bipolar Disorder

Renal Failure

Kidney Transplant 2008

Sleep Apnea

Allergies
Medications- Kidney Transplant (Wynn et al., 2015)

Prograf Immunosuppressive agent Stomatitis, oral moniliasis,

dysphagia, and esophagitis
Kidney Transplant (including ulcerative)

Cellcept (mycophenolate) Immunosuppressive agent Mouth ulceration, gum

hyperplasia, gingivitis, dry
Kidney Transplant mouth, dysphagia, oral
moniliasis, and stomatitis

Prednisone Corticosteroid No dental implications recorded

Kidney Transplant
Medications- Cardiovascular (Wynn et al., 2015)

Norvasc (amlodipine) Antihypertensive; Calcium Gingival hyperplasia

Channel Blocker
High Blood Pressure

Zetia (ezetimibe) Antilipemic Agent No significant effects or

complications reported
High Cholesterol

Labetalol Antihypertensive; beta-blocker Taste Disorder

with alpha-blocking activity
High Blood Pressure
Medications (Wynn et al., 2015)

Abilify (aripiprazole) Antipsychotic Xerostomia and changes to

salivation
Bipolar Disorder

Januvia Antidiabetic agent, Dipeptidyl Morning appts to minimize

(Sitagliptin) peptidase IV inhibitor chance of stress-induced
hypoglycemia
Type 2 Diabetes

Baby Aspirin (OTC) Anti-inflammatory and blood Increased bleeding

thinner
No note of it prescribed by MD
Patients Current Status

Diabetes

Patient does not check blood glucose daily

HbA1C: unknown (reported to be within acceptable limits)

Hypertension- Stage I

2/9/2016 B.P.: 140/90

Bipolar Disorder

Controlled
 Oral and Periodontal Condition

Gingival Hyperplasia Xerostomia

Gingival Hyperplasia

Pseudopockets

Xerostomia

AAP

Generalized Chronic Severe

Periodontitis
Treatment Alterations & Consultations

Medical Consultation for Kidney Transplant - 2010

Pt cleared for tx

No pre-med

Patient was semi-supine

Beneficial for GERD

Current Protocol for Management (Little et al., 2013)

Condition Management

Diabetes Morning appts preferred

Eat before appt

Hypertension Reduce stress

Cardiac dose of epinephrine - 0.04 mg
Orthostatic hypotension due to medication

Allergies Nitrile supplies

Penicillin Alternate antibiotic
Latex

GERD Avoid pt being flat

Reduce Stress
(Burkhart, 2013)

Bipolar Disorder Limit epinephrine

May have increased bleeding or hypotension due
to medications
Citations

Burkhart, N. W., (2013). The dental implications of long-term GERD and the development of esophageal cancer.
Dentalcare.com. http://www.dentalcare.com/en-US/dental-education/continuing-
education/ce416/ce416.aspx?ModuleName=coursecontent&PartID=0&SectionID=-1

Little, J.W., Falace, D.A., Miller, C.S., & Rhodus, N.L. (2013). Dental management of the medically compromised
patient. St Louis, Missouri: Elsevier Mosby.

Wynn, R. L., Meiller, T. F., & Crossley, H. L. (2015). Drug information handbook for dentistry: Including oral medicine
for medically compromised patients & specific oral conditions. Hudson, OH: Lexicomp.