Condition Symptoms Implications for oral health

and dental treatment

Angina - Caused by coronary heart - Pain/discomfort/tightness in chest - Patients treated with calcium channel
disease (plaque build-up in - May spread to blockers may have gum overgrowth : gum
arteries) back/neck/jaw/shoulders/arms/hands surgery may be needed
- Heart receives insufficient - Patients with stable angina (chest pain that
blood + oxygen occurs in predictable pattern) : can be
- Increases risk of heart attack treated
- Patients with unstable angina
(new/unpredictable chest pain) : no
elective procedures – emergency
treatment in hospital or office w cardiac
monitoring capability
Coronary disease - Damage/disease to coronary Narrowing of the coronary arteries (major blood Escalates periodontal disease significantly
arteries (supply heart) vessels supplying oxygen and blood to the heart)
- Usually due to plaque
buildup

Heart valve Heart murmurs (abnormal sounds), irregular During treatment, pathogens (bacteria) may
disease heartbeat, fatigue, fainting, shortness of breath, enter bloodstream and cause subacute
dizziness, swollen ankles and feet bacterial endocarditis (SBE) (infection of the
heart valves)

Rheumatic fever Illness caused by autoimmune response to
infection by bacteria, group A streptococcus
Can lead to inadequately treated strep throat or
scarlet fever
Increased risk of developing infective
endocarditis - pathogens (bacteria) may enter
bloodstream and cause SBE during dental
treatment
Insufficient attention paid to maintaining good
oral health
High blood >140/90 monthly, Fatigue, severe headache,
pressure irregular heartbeat, pounding in chest/ears/neck,
difficulty breathing, chest pain, blood in urine
Low blood <90/60 monthly, dizziness, blurred vision
pressure (possibly due to dehydration, pregnancy,
endocrine problems, etc)
Stroke Sudden numbness/weakness in face, arm, leg
(typically on one side of the body)
Sudden trouble speaking, understanding, walking,
seeing
Lack of coordination
Sudden severe headache, dizziness
Asthma Difficulty breathing (wheezing, shortness of
breath), coughing, chest tightness
Tuberculosis Coughing (sometimes blood), weight loss, fever,
night sweats
Stressful dental procedures may raise blood
pressure and cause critical complications (eg.
cardiac arrest, stroke)
Medication may cause dry mouth, increasing
risk of periodontal disease and dental decay
Periodontal disease (gum infection,gum
inflammation, tooth damage) may worsen
blood pressure and interfere with
hypertension treatment
Can lead to oral bacterial infection/ abscess
development/ inflammation due to untreated
mouth ulcers
May not maintain good oral health due to
difficulties in coordination
Increased risk of caries, calculus, gingival
disease, periodontal disease, enamel defects,
malocclusion, xerostomia, oral candidiasis,
decreased rate of saliva flow, significantly
lower salivary pH
Need to administer bronchodilator before
dental treatment)
TB bacilli may spread to the maxilla or
mandible hematogenously (by the blood)
 Can occur in the mouth with abnormal structures
and features (oral lesions)
Emphysema Alveoli become damaged and stretched - reduced
surface area for exchange of O2 and CO2
Shortness of Breath
Chronic cough
In later stages: frequent lung infections, fatigue,
reduced appetite and weight loss, sleep
problems, blue tinged lips/fingernail beds
Hepatitis A Viral disease affecting liver - contagious
Many infected people, particularly children <15 yr
show few or no symptoms
Fever, malaise, loss of appetite, diarrhoea,
naesea, abdominal discomfort, dark-coloured
urine, jaundice
Hepatitis B Yellowing of the eyes, abdominal pain, dark urine
In chronic cases : liver failure, cancer or scarring
can occur
Hepatitis C Most people have no symptoms
Elective dental procedures should not be
carried out on patients until they are declared
noninfectious
Excessive bleeding (due to reduction in
coagulation factors and platelets)
Vitamin K or platelet or clotting factor
replacement for certain oral procedures
Oral mucosa may have a yellow-brown cast
during jaundice phase of acute hepatitis and
dysgensia may also occur
Oral mucosa may have yellow-brown cast
during jaundice
Abnormal bleeding
Develop liver cancer which may metastasize to
the jae
Interferon may cause dry mouth, bleeding,
tender or enlarged gums and dysgensia
Oral mucosa may have yellow-brown cast
Abnormal bleeding
 Those who develop symptoms may have fatigue,
loss of appetite, nausea, yellowing of eyes and
skin
Gastro Heartburn usually after eating, chest pain,
oesophageal difficulty swallowing, regurgitation of food or
reflux disease sour liquid, ‘lump in throat’ sensation
GORD
Diabetes mellitus Increased thirst, Fatigue, frequent urination,
irritability, extreme hunger, blurred vision,
unexplained weight loss, presence of ketone in
urine, slow-healing sores, frequent infections
Thyroid disease Fatigue, Increased sensitivity in cold,
constipation, dry skin, weight gain, puffy face,
hoarseness, muscle weakness, elevated blood
cholesterol, thinning hair, slowed heart rate,
impaired memory erhkjfhffklf
Increased risk of liver cancer, which may
metastasize to the jaw
Linked to xerostomia and aching in the mouth
+ lichen planus and lymphocytic sialadenitis
Side effects of antiviral therapy
Mint-flavoured products should be avoided as
they relax the lower esophageal sphincter
Aspirin and non-steroidal anti-inflammatory
drugs should be avoided because they
contribute to reflux and exacerbate esophagitis
- Acetaminophen is preferable
Sore throat, gaggin, halitosis, mucositis and
sour or bitter taste in the mouth
Enamel erosion - tooth sensitivity
Oral lichen planus
Metallic taste can occur with the use of oral
hypoglycemia drug metformin
Elevated risk of dental caries at cervical regions
Accentuated response to plaque
Swollen parotid gland and increased saliva
viscosity
Odontalgia and percussion sensitivity
Periodontal changes
Slow wound healing
Delayed tooth eruption
Salivary gland enlargements
Increased susceptibility to caries and
periodontal disease
Accelerated dental eruption
Maxillary or mandibular osteoporosis
Use thyroid collar while taking X-rays
Kidney disease Fatigue, loss of appetite, tiredness, high blood
pressure, malaise, water-electrolyte imbalance,
abnormal heart rhythm, insufficient urine
production
Osteoarthritis Joint pain in the hands, neck, lower back, knees
or hips
Rheumatoid Joint pain, swelling, tenderness to touch, stiffness
arthritis in the joints (usually worse in the mornings and
after inactivity), fatigue, fever and loss of
appetite
HIV AIDS Extreme and constant tiredness, fever, chills,
night sweats, rapid weight loss, swollen lymph
glands, coughing, diarrhoea and loss of appetite
Herpes simplex Tingling, itching, or burning, sores, flu-like
symptoms, problems urinating
Abnormal healing after extraction may occur
Metallic taste from increased concentration of
urea in saliva
Red-orange discolouration of oral mucosa
Enamel erosion or hypoplasia
Xerostomia reduces saliva flow
Xerostomia which increases risk of caries
Elevate the risk of periodontal diseases
When involves TMJ, may cause malocclusion
Use of corticosteroids can lead to oral
candidiasis
Immunosuppression, oral ulceration,
stomatitis, tender or swollen gums as side
effects of DMARDs
Medication can promote periodontitis,
candidosis, oral ulceration, and reduced
salivary flow.
Increase the risk of TMD (temporomandibular
dysfunction)
Weakened immune system increases the risk
of infections in the mouth
increase the risk of mouth ulcers, thrush, dry
mouth, herpes and periodontitis
Dental hygienist should not treat the patient
when lesions are present as virus shed in
saliva.
Recurrent herpetic lesions can occur
intraorally
Joint replacement swelling, pain, stiffness, redness around the Antibiotics should be prescribed to patient
wound, wound drainage, fatigue, fever, chills and before dental treatment to prevent bacteria
night sweats. from entering the bloodstream.

Osteoporosis No symptoms in the early stage of bone loss, loss of height Increase the risk of periodontal disease, tooth loss because of
over time, stooped posture, bone fracture decreased alveolar bone density
More likely to experience poor-fitting dentures

Cancer Fever, weight loss, night sweats, headaches, indigestion, Cancer treatment can Increase the risk of infections in the
persistent lumps, swollen glands, hoarseness, itching in anal or mouth and cause mouth ulcers, sensitive gums tooth decay
genital area and blood in the urine

Radiation treatment in Redness, skin irritation, swelling, dry mouth, thickened saliva Radiation therapy, especially in the area of the head and neck,
the head and neck can damage salivary glands which can cause thick/sticky saliva
region (xerostomia) and extreme dry mouth, a dry mouth increase the
chances of tooth decay
Chemotherapy Fatigue, hair loss, easy bruising and bleeding, infection, nausea, Chemotherapy can weaken immune system and increases the
vomiting, anemia, loss of appetite, constipation risk of infections in the mouth which can cause mouth sores
and sensitive gums

Allergic reaction Mild allergic reactions: hives (itchy red spots on the skin), Be cautious not to use latex products/ certain medication
itching, nasal congestion, rash, scratchy throat, watery eyes during treatment
severe allergic reactions: diarrhea, difficulty swallowing, pain in
the chest, abdominal cramping or pain, dizziness, nausea,
vomiting, swelling of the face, eyes, or tongue, difficulty
breathing, unconsciousness