General

1. Monitor vital signs at every ap pointment because of cardiovascular and respiratory side effects.

2. The patient may require a semi-supine position for the dental chair to help with breathing.

3. Dental procedures may cause the patient anxiety which could result in an asthma attack. Make sure that the patient has his or her sympath-omimetic inhaler present or have the inhaler from the office emergency kit present.

4. Morning and shorter appointments, as well as methods for addressing anxiety levels in the patient, can help to reduce the amount of stress that the patient is experiencing.

5. Sulfites present in vasoconstrictors can precipitate an asthma attack.

6. Decreased saliva flow can put the patient at risk for dental caries, peri-odontal disease, and candidiasis. Consultation with Primary Care Provider

1. Consultation may be necessary in order to evaluate the patient's level of disease control.

2. Consultation may be necessary in order to determine the patient's ability to tolerate stress. Client/Family Teaching

1. Daily home fluoride treatments for persistent dry mouth.

2. Avoid alcohol-containing mouth rinses and beverages.

3. Avoid caffeine-containing beverages.

4. Dry mouth can be treated with tart, sugarless gum or candy, water, sugar-free beverages, or with saliva substitutes if dry mouth persists.

5. Review use, care, and storage of inhaler. Rinse out mouth and wash the mouth piece, spacer, sprayer and dry after each use.

6. Review technique for use and care of prescribed inhalers and respiratory equipment. Rinsing of equipment and of mouth after use is imperative in preventing oral fungal infections.

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