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Treatment of myasthenia. II.

Publication Date
  • Research Article
  • Medicine
  • Psychology


Dental Treatment Considerations Common questions people ask about Dental Treatment Considerations DE N TA L T R E AT M E N T CONSI DE R AT IONS Myasthenia gravis (MG) is an autoimmune neuromuscular disorder that presents challenges for both the dental practitioner and the patient. Facial and masticatory muscles may be involved and complicate dental care and treatment. Exacerbation of muscle weakness and fatigability that characterize this disorder can be precipitated by certain medications used in dentistry. The dental team should be cognizant of the medication precautions in this population, modify dental care to accommodate existing neuromuscular weakness and drug therapy, and be prepared to manage emergent complications occurring in the dental office. Dental care provision for patients with MG requires special management considerations. These include identifying and managing myasthenic weakness or crisis, avoiding the potential of harmful drug interactions, monitoring oral side effects of drugs and therapies used to treat MG, and modifying dental treatment to accommodate altered muscle strength. Appointment Scheduling It is important to realize that oral infections and the psychological stress of anticipating or undergoing dental treatment may precipitate or worsen myasthenic weakness. Short-duration morning appointments will minimize fatigue and take advantage of the typically greater muscle strength during the morning hours. Appointments are best scheduled approximately one to two hours following oral anticholinesterase medication so as to benefit from maximum therapeutic effect and decrease the risk of myasthenic weakness or crisis. Private Office or Hospital The stable MG patient with limited or mild neuromuscular involvement may be safely treated in the private dental office setting in most instances. However, the patient with frequent exacerbations or significant or pharyngeal, respiratory, or generalized we

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