PACT: Systemic Diseases

		Many systemic conditions are known to adversely affect the mouth or teeth, and these patients require additional oral care and management.
		Oral findings may be the only presenting symptom for leukemia and histiocytosis.
		Early tooth loss, especially mandibular molars, should prompt consideration of Langerhans cell histiocytosis.
		Xerostomia may occur in SLE, Sjogren's Disease, and Diabetes Mellitus.
		Gingival bleeding may be a sign of vitamin C or K deficiency.
		Vitamin C and Vitamin D deficiency may present with both bone and dental abnormalities.
		Perimolysis is a specific pattern of enamel erosion resulting from repeated emesis.
		It is important for patients to rinse their mouth after all emesis, but brushing is controversial.
		A dental evaluation should accompany the medical and psychological evaluation of a suspected eating disorder.
		Inhaled steroids increase the risk for oral candidiasis.
		Staining from iron supplements is not permanent.
		Tetracycline staining affects all teeth.
		Fluorosis preferentially affects the incisors and molars.
		Repeated acid exposure causes enamel erosion and increases caries risk.
		Rinsing the mouth after episodes of reflux or emesis can help neutralize the gastric acid.
		Caries rates are higher in children with ADHD.
		First-line therapy for Subacute Bacterial Endocarditis is Amoxicillin.
		Options for Penicillin-allergic patients include Clindamycin, cephalosporins, and macrolides.
		The American Heart Association has recently revised the guidelines for cardiac lesions requiring prophylaxis.
		Patients with known or suspected bleeding disorders should be evaluated by a hematologist prior to dental intervention.
		Routine cleanings generally do not require pre-treatment.
		Proper oral hygiene can prevent dental disease and the need for hematologic intervention.
		Tranexamic acid mouthwash can help minimize oral bleeding with dental procedures.