People who are medically compromised need special attention from the dentist. When you are dealing with a serious health matter like heart surgery, organ transplants, cancer or joint replacement - or if your health is otherwise compromised - it is very important to make sure that your teeth and gums do not become a source of infection. Studies show that poor gum and dental health can compromise your overall health. Compromised patients need special attention from the dentist to help get the best possible outcome for their medical treatment.

Pregnant patients should consult with their physician prior to any dental treatment. We will contact your physician as well for consultation regarding drug administration. We generally avoid elective care during the first trimester; second trimester and most of the third trimester are the best times during a pregnancy for elective treatment. Radiographs (X-rays) are not to be taken during the first trimester and normal precautions can be taken to take them afterwards as necessary. We will monitor for oral complications generally associated with pregnancies such as exaggeration of periodontal disease or "pregnancy gingivitis", a pregnancy "tumor" and tooth mobility.

Please see the Periodontal Disease section for more details.

Cancer treatment, whether it be radiation or chemotherapy or a combination, often wreaks havoc in the oral cavity. Proper dental care at the appropriate times can go a long way towards trying to maintain the quality of life patients were used to prior to treatment. Chemotherapy and radiotherapy in the head and neck region can often result in several symptoms in the oral cavity, such as:

Mucositis and ulceration in 32% of cases; Anemia; Bleeding and thrombocytopenia in 3% of cases; Infection (bacterial, viral, fungal) in 26% of cases; Pain (neurotoxicity) in 7% of cases; Xerostomia in 16% of cases; Caries, dentinal sensitivity, periodontal compromise in 8% of cases; Dysgeusia (taste change or loss); Trismus; Osteoradionecrosis

Oral complications compared to specific type of disease:

Leukemia (all types): 66%

Non-Hodgkin's Lymphoma: 33%

GI Malignancies: 20%

Breast Malignancies: 12%

During our examination prior to chemotherapy and/or radiotherapy initiation, we consult with the patient and take steps to remove any potential sources of infection. Furthermore, we initiate preventative measures, such as oral hygiene instruction, topical fluoride applications; management strategies for pain, mucositis, bleeding, infections, xerostomia, caries. In patients receiving radiation of the head and neck, we discuss prevention and management for osteoradionecrosis (bone breakdown), trismus, loss of saliva among other topics.

A lot of folks refer to medicine as being an art and a science. That’s because it is very difficult with the amount of diversity we see in people, to say that any one treatment or medicine will work for everyone. Unfortunately, this also means that sometimes, we do not know about adverse affects from medication until after it gets on the market. If you are on medication for osteopororis, Paget’s disease or chemotheraphy, please read carefully. Poorly fitting dentures, existing gum disease or other dental infections in patients taking these medications have been implicated in a serious complication called osteonecrosis – which literally means “bone death”. Treatment is costly, complicated and not always successful. Once again, the old adage prevention is better than cure applies.

If you are on bisphosphonate medication for osteoporosis or any other condition, please talk to your physician and dentist. It is recommended that patients receive a full dental examination before starting these medications.