e. Medication. The dental officer, during an initial examination and before
starting any dental treatment, routinely asks a patient if he is taking any medication. If so,
a notation is made on the record as to the type and amount of drug being taken. Special
considerations in providing dental treatment and in prescribing additional drugs will be
determined from this information.
f. Medical Treatment. During a dental examination, the dental officer asks the
patient if he is under medical treatment and, if so, for what particular condition. This will
enable the dental officer to determine the best plan for dental treatment.
g. Systemic Conditions. There are a number of oral manifestations of systemic
diseases, if discovered while taking the medical history, which must be considered
carefully in planning and carrying out the course of treatment. Because of physical
standards for active military duty, these conditions are not as common in the military
community as in other segments of the population. Some of these conditions, including
potential dangers and precautions to be taken, are given below.
(1) Congestive heart failure. Patients with congestive heart failure have
hearts that have been weakened to the extent that they can no longer fulfill the body's
demands. A physician is usually consulted before oral surgery or other dental treatments
are performed.
(2) Rheumatic heart disease. Rheumatic fever is a disease that may affect
the valves of the heart. Heart valves that have been damaged (rheumatic heart disease)
by rheumatic fever are susceptible to infections from bacteria that could be forced into the
bloodstream during extraction of teeth or other dental procedure. Should a patient with a
history of rheumatic fever require dental care, the dental officer will normally consult the
patient's physician and institute prophylactic antibiotic treatment before performing the
indicated treatment.
(3) Coronary artery disease. Patients with coronary artery disease (disease
of the arteries that supply blood to the heart) may experience pressure or pain in the
chest called angina pectoris. Pressure or pain occurs when narrowing of the coronary
arteries prevents adequate oxygen to the heart muscles. Attacks may be brought on by
nervousness and physical or emotional stress. Patients with a known history of angina
pectoris should be treated only after every precaution has been taken to minimize
nervousness and stress. Usually, a physician is consulted before these patients are
treated. The patient who has angina pectoris usually carries his own supply of
nitroglycerin.
(4) High blood pressure (hypertension). The dental officer normally will
consult the patient's physician before surgery or any extensive dental treatment on a
patient with elevated blood pressure. Premedication, selection of the anesthetic agent,
and the duration and nature of anticipated surgery or dental manipulation all require
careful consideration.
MD0503
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