Pagets Disease

1. Effect on oral health 2. Medications effect on oral health 3. Effect on treatment/ management 4. Assess severity/ level of control 5. Symptoms of loss of control/ attack 6. Precautions in place 7. Drug prescription/ interactions 8. Antibiotic prophylaxis 9. hange in current medication 10. Effect on blood pressure/ bleeding 11. Allergies 12. Patient instruction 13. !P consultation 14. Effect on dental treatment on oral health A disease of disordered bone resorption and production Large high ! acti"e osteoc asts cause bone oss# osteob asts tr! to repair the oss $igh turno"er and conse%uent a tered structure &hic'ened (ea'ened defor)ed bone Affects skull# spine# pe "is# egs

1. Effect on oral health - *a( in"o "e)ent - +one oss at root , tooth oosening- oss - +one gro(th , )a occ usion# teeth spreading# h!perce)entosis - .oor denture fit - /ifficu t e0traction# e0cess b eeding# osteo)!e itis - 1racture 2. Medications effect on oral health - +isphosphonates after co))encing bisphosphonate therap!# dentist shou d )onitor 2$ regu ar ! (ith - c inica denta e0a)inations - radiographs - denta treat)ent3 )aintain ora hea th# a"oid e0tractions# ensure dentures fit (e 4as a oss of osseointegration )a! occur5 A procedures in"o "ing bone 4e.g. i)p ant p ace)ent# orthodontic tooth )o"e)ent# periapica or radicu ar surger!# or root p aning5 re%uire carefu consideration and infor)ed consent before proceeding 6a citonin 4suppresses bone resorption5

14. Effect of dental treatment on oral health - 2steonecrosis 7 e0tractions# poor ! fitting dentures