Systemic diseases relevant to dentistry
Type 1 = insulin dependent (autoimmune). Type 2 = insulin resistant (90%). HbA1c = 3-month average glucose. HbA1c <7% = good control. Dental: delayed healing, increased infections, periodontal disease.
IE prophylaxis = high-risk cardiac conditions + invasive dental procedures. INR for warfarin patients: Safe for extraction if INR <3.5. Aspirin: Don't stop for dental extraction. Hypertension: BP >180/110 = postpone treatment.
Hemophilia A = Factor VIII. Hemophilia B = Factor IX. Von Willebrand = most common inherited bleeding disorder. PT = extrinsic pathway (warfarin). PTT = intrinsic pathway (heparin). INR = standardized PT.
Hep B = highest risk of needle stick (30%). Hep C = most common chronic. HIV = lowest needle stick risk (0.3%). Post-exposure prophylaxis = within 72 hours. Universal precautions for ALL patients.
Type I = immediate (anaphylaxis) = IgE. Type IV = delayed (contact dermatitis) = T-cell. Latex allergy = Type I or IV. First drug in anaphylaxis = Epinephrine 0.5mg IM (anterolateral thigh).