Many aspects of a patient’s medical history may be particularly

relevant to his or her periodontal care. These are discussed

further in subsequent chapters but may include the

following:

• Medical problems can increase susceptibility to

periodontal diseases (e.g., diabetes and HIV) and may, in

whole or in part, explain the particular clinical

presentation and disease severity.

• Medical problems can have periodontal and other oral

manifestations (e.g., leukaemia and mucocutaneous

disorders).

• Prescribed and nonprescribed medications can have oral

and periodontal side effects (e.g., calcium channel

blocker or phenytoin).

• Is periodontal infection a risk factor for systemic diseases

or conditions that affect overall health? There is

emerging scientific data on the association of

periodontal disease with common systemic medical

problems such as cardiovascular disease, stroke, diabetes,

osteoporosis, and low-birth-weight infants. Future

targeted anti-inflammatory therapies for patients with

periodontal disease may modulate inflammation and,

hence, lower risk for systemic conditions.

• Particular existing or previous medical conditions or

medications may need specific precautions to be taken

to avoid complications during or after treatment (e.g.,

antibiotic prophylaxis and patients on certain

medications such as anticoagulants or

bisphosphonates).

• Treating certain conditions may present additional risk to

the dental team (e.g., communicable diseases) and may

alter the way treatment is provided (e.g., not using

ultrasonic instrumentation to avoid producing aerosol).