Professional Documents
Culture Documents
1
Dewi Agustina
Oral Medicine FKG UGM
MANAGEMENT OF MEDICALLY
COMPROMISED PATIENTS
refers to those patients who have medical
conditions which affect the dental treatment or
manifest as a specific oral and dental problem
Perlu modifikasi perawatan dental
Rujuk : asesmen medik definitif
The term of medically compromised
patients :
Daftar masalah pasien:
Chief complaint
Potential medical complication
Oral diseases and conditions
Masalah --- Chief complaint
Pain
Acut infection
Bleeding
Traumatic injury
Immediate
attention
&
urgent care
Potential medical complication
Kondisi medik pasien
yang dapat mengalami
komplikasi selama
perawatan dental
perlu modifikasi
perawatan
dental
Potential medical complication
Diagnosed medical
conditions
Current medications
Hypersensitivity
Undiagnosed medical
conditions
perlu
modifikasi
perawatan
dental
08/12/2011
2
Diagnosed medical conditions
Asthma
Epilepsy
Bleeding disorders
Pregnancy
Diabetes
Risk of serious
complication?
perlu modifikasi
perawatan
dental
perlu dicermati:riwayat
pengobatan dan status
fisiknya bila tidak jelas
-- rujuk/konsultasi
Current medications
Pengobatan yang sedang
dialami pasien
Perlu dipahami aksi,
interaksi dan efek
samping obat
Hypersensitivity
Alergi, idiosinkrasi
Hindari
obat yang sama
Undiagnosed medical conditions
Kondisi medik
yang belum
terdiagnosa atau
perlu
diwaspadai
Tidak mempunyai implikasi
langsung dengan perawatan
dental saran - konsultasi
Mempunyai implikasi langsung
dengan perawatan dental
rujuk- konsultasi medik
Evaluation of MCP :
Risk of dental procedures
Patientss medical risk
Physician consultation
Dental specialist consultation
Laboratory test
Evaluation of medications
Health status classification system
Level 1 : A patient with no systemic disease
(able to run for 2 min/longer ; to climb 2 flights of stairs
w/o short of breath/any discomfort)
Level 2 : A patient with mild systemic disease
(able to walk 2 city blocks at a fast pace; to climb 2 flights
of stairs w/o short of breath/any discomfort; healthy
individual with extreme fear of dental tx)
Level 3 : A patient with severe systemic disease
(able to walk at a regular pace with limited physical
activity)
Level 4 : A patient with incapacitating or life-threatening
disease
(unable to do light activity for even a short period of time
and may experience discomfort while a rest)
ASA (MED Type) Risk Classification of Dental Patients
(After Crawford, 2002)
ASA I (MEDType I)
A normal healthy patient
ASA lI (MEDType lI)
A patient with mild to moderate
systemic disease
Does not interfere with daily
activities
No treatment modifications are necessary