1 Protocols for the DENTAL MANA GEMENT OF MEDICA LL Y COMPL EX PA TIENTS TOPIC PAGE 1. Bleeding Problems (including anticoagulants) 2 2. Cardi ac Probl ems (heart mur mur s, cardi ac defects ) 5 3. Ca rdiovascul ar Problems (high blood pressure, arrhythmias) 10 4. Central Nervous System Problems (seizures, str oke) 14 5. Diabetes 17 6. Immunosup pression 19 7. Infecti ous Diseases (tubercu losis, hepatit is, HIV , herpes, flu ) 21 8. Kidney Probl ems 26 9. Liver Probl ems 27 10. Pregn ancy 29 11. Prosthetic Joint s 31 Protocols compiled by: Peter L. Jacobsen, Ph.D., D.D.S Professor, Department of Pathology and Medicine Director, Oral Medicine Clinic Please direct all comments, edits and suggestions to him at: [email protected]or call (415) 929-6609 or fax (41 5) 929-6654 or write to: Department of Pathology and Medicine University of the Pacific, School of Dentistry 2155 Webster Street San Francisco, CA 94115 Updated July 2011