FlashcardsMedical conditions: Endocrine, GI & renal

Crohn disease flashcards

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How does Crohn disease affect dental management?

1 / 6

How does Crohn disease affect dental management?

Refer: persistent swelling or atypical ulcers warrant oral medicine/pathology assessment and possible biopsy.
Interpret biopsy: noncaseating granulomas support a differential that includes Crohn disease; they do not prove intestinal involvement.
Methotrexate: avoid nitrous oxide anesthesia because it can increase methotrexate toxicity; check planned antibiotics and analgesics for interactions. Prescribing information, Drug Interactions: Nitrous Oxide.
Before treatment: Review disease activity, nutrition, steroid exposure, and each immunosuppressant. Coordinate adrenal and infection precautions for the proposed procedure rather than assuming all patients need stress steroids or antibiotics
Flare prevention: Avoid NSAIDs; they can trigger flares
Oral treatment: Topical steroids for oral lesions; nutritional deficiency screening
After extraction: Acetaminophen is the first analgesic choice after extraction.

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Exposure or finding	Dental consequence
Methotrexate	Avoid nitrous oxide anesthesia and check planned drug interactions.
Steroid exposure	Assess adrenal suppression; obtain coverage when known or suspected, rather than automatically stress-dosing everyone.
Biologic/immunomodulator therapy	Review infections, monitoring, and cytopenias; coordinate relevant labs before surgery.
Active disease or poor nutrition	Reassess readiness, healing, and oral lesions with GI/oral medicine.