General

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

2. Early morning and shorter appointments may be of benefit for anxious patients.

3. Antianxiety drugs, such as ben-zodiazepines or nitrous oxide, can be prescribed if the anxiety associated with a dental appointment precipitates the patient's angina attack.

4. Talk with patient about frequency of angina attacks (disease control).

5. Stress from a dental procedure may adversely affect the patient's cardiovascular status. Assess patient risk.

6. Have the patient sit up slowly and remain seated for at least two minutes after being supine in order to minimize the risk of orthostatic hypotension.

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

8. Patients on sodium restricted diets should receive sodium-containing fluids (i.e., saline solution) with caution.

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Anxiety and Depression 101

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