Management of Medically Compromised Patients

The management of medically compromised patients is an essential aspect of modern dental practice, as an increasing number of patients present with systemic diseases that may influence dental treatment. Safe dental care begins with a comprehensive medical history, assessment of current medications, allergies, vital signs, and relevant laboratory investigations, followed by medical consultation whenever necessary. The patient's medical condition should be evaluated to determine whether it is stable or uncontrolled before initiating treatment. General principles include scheduling short morning appointments, minimizing stress and anxiety, providing effective pain control, monitoring vital signs, and being prepared to manage medical emergencies. Patients with cardiovascular diseases such as angina, myocardial infarction, arrhythmias, heart failure, and hypertension require treatment modifications, including limiting vasoconstrictor use, avoiding excessive stress, and postponing elective procedures when indicated. Antibiotic prophylaxis is recommended only for selected high-risk patients susceptible to infective endocarditis undergoing invasive dental procedure.