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Introduction

The initial medical information can be obtained by various means

Assess a patient’s potential for complications

Assess the need for dental modifications to reduce medical complications

Assess the appropriate setting for treatment of a patient with medical complexity

Classification of a patient’s medical complexity

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Medical history

A medical history is a starting point for a dialogue with a patient about their medical status. Only a select number of questions are usually included in a health questionnaire, but each affirmative answer should lead to additional questions, which are also provided for you.

The initial medical information can be obtained by various means:

Assess a patient’s potential for complications:

The most common concerns that should be addressed to avoid medical complications are a patient’s:

  • ability to achieve hemostasis
  • susceptibility to infections
  • risk for side-effects to drugs and drug interactions
  • ability to heal after trauma
  • ability to cope with stress

Assess the need for dental modifications to reduce medical complications:

  • need for adjunct measures to achieve hemostasis
  • need for antibiotic prophylaxis
  • need for glucocorticosteroid replacement therapy
  • use pre-medication to reduce anxiety
  • use of sedation
  • need to adjust the length of procedure

Assess the appropriate setting for treatment of a patient with medical complexity:

  • out-patient in a non-hospital or hospital setting
  • short-procedure unit
  • operating room

Classification of a patient’s medical complexity:

American Society of Anesthesiologists (ASA) status classification. Although ASA should ONLY be used to assess a patient’s outcome from undergoing general anesthesia it is being used to assess a dental patient’s risk from dental procedures using local anesthetics.

Medical Complexity Status (MCS) is a system developed especially for out-patient care to assess the risk of routine dental procedures.

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