Dental considerations in patients with respiratory problems.
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Claramunt Lozano, Ariadna; Sarrión Pérez, María Gracia; Gavaldá Esteve, Carmen
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Aquest document és un/a article, creat/da en: 2011
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Many respiratory disorders can compromise routine dental care and require special treatment for the affected patients. Patients often visit the dental clinic with respiratory problems already diagnosed by other specialists. The
dental professional therefore must provide correct dental care in the context of such a diagnosis. The present study
offers a literature review of those respiratory disorders which can have implications for dental care. Chronic obstructive pulmonary disease (COPD) and asthma require special measures, such as working with the patient in the
vertical position, since some of these subjects do not tolerate decubitus. On the other hand, patients with COPD can
suffer infectious lung diseases secondary to the aspiration of microorganisms in the presence of deficient periodontal conditions. The treatments received by patients with respiratory diseases can also influence their oral health. In
this sense, it has been shown that inhalatory medication used for asthma can cause oral disorders such as xerostomia, oropharyngeal candidiasis and an increased presence of caries (due to the action of β-agonists), as well as gingivitis. In contrast, oral manifestations of tuberculosis are infrequent. The clinical appearance of the lesions is very
similar to that of squamous cell carcinoma; it is therefore important to establish a correct differential diagnosis in
such cases. Mention also will be made of patients with obstructive sleep apnea syndrome (OSAS), characterized by
critical narrowing and occlusion of the upper airways during sleep. In this context, the dental professional is often
directly implicated in the management of such patients by preparing and fitting oral devices designed to advance the
mandible. Lastly, mention will be made of dental management in the event of foreign body aspiration, where rapid
intervention by the dental professional is critical. The basic approach in such cases is adequate prevention.
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