Question

A patient, who has been previously treated for chronic periodontitis and has been followed by your...

A patient, who has been previously treated for chronic periodontitis and has been followed by your dental team for several years, calls your dental office with a concern. She is scheduled to undergo a liver transplant and has been warned by her physician that the medication she will need will make her more susceptible to infections. She asks if these medications might have an effect on her continuing treatment for periodontitis. How might you respond to her concern?

0 0
Add a comment Improve this question Transcribed image text
Answer #1

Until the last several years liver transplantation was considered an experimental treatment procedure. Nowadays virtually any disease process, that is in terminal stage, is treatable with transplantation. The introduction of cyclosporine in 1980 and the recent use of OKT3 monoclonal antibody now allows a 5-year survival rate of 60-70%. The causes of early death of patients who survive after surgery are infective complications, multiorgan failure and acute rejection of the allograft. In the literature and in our experience, bacterial sepsis is the most common cause of deaths occurring during the first postoperative months while most deaths after one year are generally related to chronic rejection of the allograft. The risk of infection is also increased by the over-immunosuppression of these patients always treated with a high dose of immunosuppressive agents when evidence of acute graft rejection is found. Regarding these problems, patients being prepared for liver transplantation should be evaluated for their dental health. The medical indications of 80 transplant recipients and the current status of liver transplantation are reviewed in this article. We describe the dental status of these patients that should receive indicated dental care before surgery. Most patients (90%) were affected by chronic active hepatitis while the number of primitive cirrhosis was significantly lower. Very poor dental hygiene was found in 85% of patients while 45% were affected by advanced periodontal disease and 12% by a chronic gingivitis. Dental caries were observed in 67% while in 20% of cases endodontic periapical lesions were found and only 2% of these resulted as radicular cysts. Indicated dental care consisted in 87% of cases in dental hygiene instructions, in 85% in scaling and root planing, in 63% in conservative restorations and in 40% in endodontic treatments. Dental treatment guidelines before transplantation are described with particular attention to prevent risk of infection using antibiotic prophylaxis for invasive dental procedures. Dentists, after surgery must be also prepared to deal with excessive bleeding related to a severe liver disfunction; for this purpose an appropriate protocol is also described. The monitoring of oral and general health conditions and the achievement of specific protocols of prophylaxis are helpful in the prevention of complications and are fundamental to obtain the best results with liver transplantation improving the quality of life of these patients.

Add a comment
Know the answer?
Add Answer to:
A patient, who has been previously treated for chronic periodontitis and has been followed by your...
Your Answer:

Post as a guest

Your Name:

What's your source?

Earn Coins

Coins can be redeemed for fabulous gifts.

Not the answer you're looking for? Ask your own homework help question. Our experts will answer your question WITHIN MINUTES for Free.
Similar Homework Help Questions
  • a 67 y.o. female patient who presents with c/o dyspnea and a chronic cough for weeks....

    a 67 y.o. female patient who presents with c/o dyspnea and a chronic cough for weeks. She is a smoker since she was a teenager. This is a follow-up visit after testing has been completed. Testing completed included: Pulmonary Function Testing which show a definite blockage in her airflow; A Chest X-Ray which shows a lesion Bronchoscopy washings which showed malignant cells. Histology is a squamous cell carcinoma Her diagnosis is bronchogenic lung cancer. This patient is scheduled for surgery,...

  • The parents of a young patient currently being treated by your dental team inform you that...

    The parents of a young patient currently being treated by your dental team inform you that following a length illness, their daughter has recently been diagnosed by her physician with a neutrophil defect. Neutrophils are also known as polymorphonuclear leukocytes. They inquire about any dental implication of this diagnosis. How might you respond to this inquiry.

  • a 67 y.o. female patient who presents with c/o dyspnea and a chronic cough for weeks....

    a 67 y.o. female patient who presents with c/o dyspnea and a chronic cough for weeks. She is a smoker since she was a teenager. This is a follow-up visit after testing has been completed. Testing completed included: Pulmonary Function Testing which show a definite blockage in her airflow; A Chest X-Ray which shows a lesion Bronchoscopy washings which showed malignant cells. Histology is a squamous cell carcinoma Her diagnosis is bronchogenic lung cancer. 1. Why did this patient have...

  • Mrs. E, is the first patient of the afternoon in your periodontal office. She is new...

    Mrs. E, is the first patient of the afternoon in your periodontal office. She is new to the practice. She is a 50 year old lady who has only lived in the United States for the last 3 years. Her English skills are minimal, but she works as a medical researcher, so you assume that she understand medical terminology. Mrs. E has generalized moderate chronic periodontitis with generalized horizontal bone loss on her posterior teeth. You determine that periodontitis instrumentation...

  • Scenario 2 MG is a 78 year old woman who has previously been diagnosed with atherosclerosis...

    Scenario 2 MG is a 78 year old woman who has previously been diagnosed with atherosclerosis and now with atrial fibrillation. She has previously been on nitroglycerin for intermittent chest pain. She has been prescribed warfarin (coumadin). 1. Please explain how this warfarin (coumadin) works for her. 2. What teaching would the RN need to provide? Six months later, M G falls. She stated she was light-headed. Her cardiologist performs a cardioversion and prescribes amiodarone (cordarone). 3. Please provide patient...

  • Scenario 1 RR is a 58 year old man who has had been diagnosed with hypertension...

    Scenario 1 RR is a 58 year old man who has had been diagnosed with hypertension of 178/92 and hyperlipidemia. Over the course of 1 year he has had several blood pressure checks and medications have been added. Currently his blood pressure is running 128/66 He is currently prescribed metoprololopressor), lisinopril (zestril), and hydrochlorothiazide for the hypertension and pravastatin (pravachol). 1. When he asks the nurse why he has so many medications now that his blood pressure is low -...

  • Case Study: The nurse is assigned to care for Tina, a 14-year-old who has just received a kidney transplant. She wa...

    Case Study: The nurse is assigned to care for Tina, a 14-year-old who has just received a kidney transplant. She was fortunate to have received the kidney very quickly; she was not on the transplant list long. Tina's grandmother, who is her guardian, states that she is concerned about taking Tina home because of all of the medications Tina will be taking. Tina tells the nurse, “The other nurses keep trying to teach me about this medication called cyclosporine. My...

  • A new patient in your office reports that she has recently been diagnosed with diabetes mellitus...

    A new patient in your office reports that she has recently been diagnosed with diabetes mellitus and that her physician suggested that she should have a dental checkup. The patient confides in you that she feels like this disease is really changing her lifestyle. She laughingly says “I have always had such good reports from my previous dentist, and I just don't really see why I need to be worried about my teeth now” Based upon what is known about...

  • 1. An 84-year-old gentleman has been admitted to your unit. Because he is not taking his...

    1. An 84-year-old gentleman has been admitted to your unit. Because he is not taking his medications as prescribed by his primary care physician, he has been having ongoing problems keeping his diabetes and high blood pressure under control. What data do the nurse need to gather based on the above information?What questions should the nurse ask when caring for this client? The nurse is updating her medication list. She asks the client if she is taking any over-the-counter medications,...

  • Sophie Helms, an elderly patient, has just been given a new anti-hypertensive medication, enalapril 5 mg...

    Sophie Helms, an elderly patient, has just been given a new anti-hypertensive medication, enalapril 5 mg once daily. She also has Type II diabetes and takes metformin 500 mg one tablet twice a day along with one baby aspirin a day. She is calling in and asking how she should take her new medication and if it interacts with any of her other medications. What factors might have an impact on the potential effect of the new medication? Are there...

ADVERTISEMENT
Free Homework Help App
Download From Google Play
Scan Your Homework
to Get Instant Free Answers
Need Online Homework Help?
Ask a Question
Get Answers For Free
Most questions answered within 3 hours.
ADVERTISEMENT
ADVERTISEMENT
ADVERTISEMENT