General

1. Monitor vital signs at every appointment because of cardiovascular side effects.

2. Decreased saliva flow can put the patient at risk for dental caries, perio-dontal disease, and candidiasis.

3. Patients on chronic drug therapy may develop blood dyscrasias. Symptoms include fever, sore throat, bleeding, and poor wound healing.

4. Oral inhalers can cause oral candi-diasis. Place patient on frequent recall because of oral adverse effects.

5. Avoid prescription and over-the-counter aspirin-containing products.

6. Observe for signs of oral infections because corticosteroids tend to mask them.

7. Prophylactic antibiotic therapy may be necessary if surgery or deep scaling is necessary. Steroids can delay the healing process and mask signs of infection.

8. Steroids can cause immunosuppression. Determine the patient's steroid dose and assess for risk of stress tolerance and immunosup-pression.

9. Patients receiving chronic steroid therapy (> 2 weeks) may require a temporary increase in their dose for dental treatment.

10. Determine the reason for steroid use.

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