PEOPLE must be aware of the importance of dentists knowing their medical history (for example, diabetes and heart disease) to determine whether the patient is fit enough to undergo certain procedures.

No patient should suffer any deterioration of health because of dental treatment. It is, therefore, essential to establish as clearly as possible, within practical limitations of dental practice, the presence and significance of medical problems likely to affect oral care.

The health and life expectancy in many countries are increasing, mainly because of improved social conditions, preventative medicine, the improved ability to treat the main killing diseases – myocardial infarction (heart attack), cerebrovascular accidents (stroke) and improvements in the medical care of hitherto fatal diseases.

There are also relatively new diseases, such as AIDS, COVID-19 and a range of other problems because of advances in medical and surgical care. Thus, more people are surviving with chronic illness, and the population of elderly people is increasing.

Oral health care has not always been forthcoming for patients with medical problems, and oral diseases are not always recognised as part of a generalised disorder.

There is little, if any, excuse for dentists’ unwillingness to care for seriously ill patients, as it would be a clear professional error.
Compromised persons present, in general, few special treatment problems for the dental practitioner working with local analgesics only. Notwithstanding, although in rare circumstances, patients can die because of sequelae resulting from lack of oral health care. This is apart from the fact that death is relatively common in persons lacking the diagnosis and treatment of oral lesions, which may eventually prove to be cancerous.

The prevalence of medical disorders that might affect dental treatment depends on the type of patient. Although everyone should be questioned on their medical history, the elderly, handicapped and the hospitalised should be especially medically assessed before dental treatment.

In societies where it is common for patients to request to have their treatment done under general anesthesia, there is a greater need to carry out a medical examination. It should be noted that even though dental fear and anxiety are totally eliminated because the patient is asleep during dental procedures, the serious medical risk involved when general anaesthesia is induced should be a concern. In my opinion, dental fear and anxiety are not sufficient justification for the use of general anaesthesia in dentistry.

The primary reason it is so essential for medical assessment to be done on a patient seeking medical treatment is that many dental procedures can negatively impact patients’ wellbeing when certain medical conditions exist. In this country, because it is not usual for a patient to sue a dentist for malpractice or professional negligence, dentists generally disregard their duty to screen their patients adequately. Another major reason is that Guyanese dental patients are not accustomed to having their dentist request heart tests, blood and urine tests, etc., or be questioned about their medical history. When this is done, patients often consider it as inappropriate. This is an unfortunate reality; patients themselves should do their own screening for their own good or voluntarily submit information on their general health to the dental practitioner.