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Oral health care considerations for patients with a stroke or cerebrovascular accident (CVA), transient ischemic attack (TIA), or reversible ischemic neurologic deficit (RIND):

  • Poor oral hygiene may be associated with a person’s impaired motor functions, or depression, when regards for personal hygiene may be neglected.
  • Monitor blood pressure.
  • Patients with a history of a non-cardio-embolic ischemic stroke has an increased risk of a recurrence with a systolic blood pressure >150 mm Hg.
  • Use antianxiety agents as needed.
  • Follow anticoagulation protocol when indicated.
  • Address comorbidities, such as depression, memory problems, or motor impairment.
  • Address underlying diseases and conditions, such as MI, CHF, left ventricular dysfunction, mitral and aortic stenosis, prosthetic heart valve, and atrial fibrillation.
  • Recognize signs and symptoms of stroke/TIAs. These include, among others, minimal to severe motor dysfunction, sensory impairment, visual defects, speech difficulties, dysphagia, dizziness, seizures, dyspnea, sleep problems, and memory deficits. In addition, depression is a common condition affecting many patients after a stroke.
  • If any of the following occur, stop all dental care and call emergency medical services:
    • sudden numbness or weakness of the face, arm or leg, especially on one side of the body;
    • sudden confusion, trouble speaking or understanding;
    • sudden trouble seeing in one or both eyes;
    • sudden trouble walking, dizziness, loss of balance or coordination;
    • sudden severe headache with no known cause.
  • Encourage patients with a history of TIA and RIND to seek medical evaluation.
  • Be aware that patients with a history of TIA and RIND are high risk of developing a stroke.

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