Universitat Internacional de Catalunya

Dentistry for Special Patients

Dentistry for Special Patients
3
10469
5
Second semester
OB
Main language of instruction: Spanish

Other languages of instruction: Catalan, English

Teaching staff


 

 

Thursday at 3 p.m. By appointment via e-mail to the lecturer: mribera@uic.es

 

Introduction

 The subject Dentistry for Special Patients deals with the field of dentistry that cares for patients with medical and pharmacological conditions and involves specific and differentiated treatment from the dentist to the treatment provided for other patients. The subject also covers scenarios resulting from caring for uncooperative patients, those with psychological or physical disorders that require intervention, and specific means and procedures.

 

Pre-course requirements

 There are no prerequisites

Objectives

  General objectives

A. Provide the student with the knowledge, skills and abilities required for the prevention, diagnosis and treatment of abnormalities and diseases of patients with medical complications and complex physical and medical disorders.

B. Train the student in the scientific method applied to the study, evaluation and solution of dental health problems of patients with medical complications and complex physical and medical disorders.

C. Train the student towards eventual specialization, research or teaching.

Intermediate objectives

1. Acquire the skills and attitudes necessary for the clinical examination of patients with medical and pharmacological conditions and complex physical and medical disorders. Obtain and evaluate clinical, radiographic and complementary data of the aforementioned patient and carry out a diagnostic, prognostic and therapeutic approach to the patient's dental health status.

2. Distinguish the characteristics of the diagnosis and the therapeutic approach in personalized dental care for patients with disabilities and patients with complex medical conditions.

3. Identify and describe the etiological and risk agents of oral diseases in patients with medical complications and / or complex physical and medical disorders.

4. Train students to carry out the main methods and techniques of treatment, and in the control and prevention of oral diseases collectively for selected patients.

5. Master individual and community educational techniques for patients with disabilities or with a medical condition.

6. Train the student to describe the oral health condition and dental treatment needs of the different groups of patients mentioned above.

7. Know and describe the different groups of patients with disabilities according to their abilities, their degree of dependency, their social environment and their place of residence.

8. Know the different public health programs designed for dental care of this group.

9. Train the student to use conscious sedation techniques orally and by inhalation with nitrous oxide

Competencies

  • 15 - Being familiar with the general pathological characteristics of the illnesses and disorders that affect organic systems, specifically those which have dental repercussions.
  • 21 - Knowing how to undertake a full dental exam, including the necessary X-ray and complementary exploratory tests, as well as obtaining suitable clinical references.
  • 23 - Establishing a diagnosis, prognosis and suitable treatment planning for all the different clinical areas of Dentistry, being competent in terms of the diagnosis, prognosis and writing up the dental care plan for patients who require special care, including medically compromised patients (such as diabetics, those with hypertension, a depressed immune system or are anticoagulated, etc) and patients with disabilities.
  • 31 - Knowing about the National Healthcare System, as well as the basic aspects of healthcare legislation, clinical management and the correct use of healthcare resources, and understanding the importance of the role of the dentist in the field of Primary Healthcare
  • 51 - Knowing about the organisation and provision of oral healthcare in the community, both private and public, as well as general healthcare and the role of the dentist in these fields
  • 54 - Knowing the role of the dentist within the healthcare professions and working with other healthcare professionals and other members of the dentistry team
  • 58 - Knowing the general pathological characteristics of the illnesses and disorders that affect organic systems
  • 59 - Knowing the oral manifestations of systemic diseases
  • 60 - Knowing about general and clinical pharmacology for dental practice
  • 61 - Knowing the pharmacological grounding for the various anaesthetic techniques, both local and general, as well as the role of sedation and general anaesthesia in terms of managing dental patients
  • 62 - Conocer y manejar las emergencias y urgencias médicas más frecuentes en la práctica odontológica y en las técnicas de reanimación cardiorrespiratoria básica
  • 69 - Identifying patients who require special care, recognising the characteristics and peculiarities of such cases
  • 72 - Appropriate medical prescriptions, while being aware of their guidelines and warnings, systemic effects and repercussions on other organs
  • 75 - Identifying, evaluating and attending to medical emergencies which may arise during clinical practice and apply cardiopulmonary recuscitation techniques; manage severe infections, including pharmaceutical prescriptions and simple surgical aspects

Learning outcomes

U.1. INTRODUCTION. GENERAL AREAS OF DENTAL HEALTHCARE FOR PATIENTS WITH MEDICAL CONDITIONS

U.2. PATIENTS WITH CARDIORESPIRATORY CONDITIONS

U.3. PATIENTS WITH HAEMATOLOGIC PATHOLOGIES

U.4. PATIENTS WITH LIVER DISEASE

U.5. PATIENTS WITH ENDOCRINE AND METABOLIC DISEASES

U.6. PATIENTS WITH KIDNEY DISEASE

U.7. PATIENTS WITH AUTOIMMUNE DISORDERS

U.8. PATIENTS WITH NEURODEGENERATIVE AND PSYCHIATRIC DISORDERS

U.9. PREGNANT AND BREASTFEEDING PATIENTS

U. 10. TREATMENT UNDER SEDATION. GENERAL ANAESTHESIA

U.11. MENTALLY HANDICAPPED PATIENTS

U.12. EMERGENCIES IN THE DENTAL PRACTICE

U.13. DRUG INTERACTIONS

U.14. PATIENTS WITH INFECTIOUS PATHOLOGIES, HEPATITIS, HIV 

U.15. PATIENTS WITH CANCER

                 U.15.1 CANCER PATIENTS. MALIGNANCIES OF THE LYMPHATIC AND HAEMATOPOIETIC SYSTEM

                U.15.2 PATIENTS UNDERGOING CHEMOTHERAPY OR RADIOTHERAPY


- Contents

UNIT 1

U.1. INTRODUCTION. GENERAL AREAS OF DENTAL HEALTHCARE FOR PATIENTS WITH MEDICAL CONDITIONS

 

LEARNING OUTCOMES

 

By the end of this unit, students shall be able:

  • To understand the general or systematic diseases affecting dental activity
  • To assess the preventative measures in dentistry that must be followed in order to prevent medical complications
  • To understand increased risk and the risk relating to suffering oral diseases entailed by each general disease
  • To know the prevalence of the most common general diseases affecting dental practice
  • To assess the expected frequency of the presentation of patients with certain conditions
  • To understand some legal areas relating to the treatment of patients with physical or psychological limitations or medical conditions
  • To understand the most significant diseases or syndromes that cause physical or psychological limitations and their relationship with the different areas of dentistry

UNIT 2

U.2. PATIENTS WITH CARDIORESPIRATORY CONDITIONS

 

 

U.2.1. PATIENTS WITH HEART DISEASE

 

LEARNING OUTCOMES

 

By the end of this unit, students shall be able:

  • To understand the pathophysiology of the heart and the functioning of the heart valves
  • To know the areas of the heart valves that condition dental practice
  • To learn the concept and consequences of the cardiomyopathies in dental care
  • To distinguish between the types of coronary heart disease
  • To understand the concept of coronary insufficiency and the specific nature of dental care for these patients
  • To understand the concept of cardiac insufficiency and the specific nature of dental care for these patients
  • To understand the concept of arrhythmia, its pathophysiology, classification and what must be taken into consideration when treating a patient with arrhythmia
  • To understand the specific nature of dental care for patients with hypertension
  • To understand the etiopathogeny of bacterial endocarditis
  • To understand the risks of suffering from bacterial endocarditis for patients with a history of heart disease
  • To assess the need for preventative treatment for bacterial endocarditis pursuant to the type of dental intervention
  • To distinguish situations whereby the prophylaxis of bacterial endocarditis is not necessary
  • To know the ways of minimising the appearance of resistant strains during the prophylaxis of bacterial endocarditis
  • To understand the antibiotic guidelines for the prophylaxis of bacterial endocarditis
  • To understand the management of the prophylaxis of bacterial endocarditis for patients with joint replacements

 

 

U.2.2. PATIENTS WITH RESPIRATORY PATHOLOGIES

 

LEARNING OUTCOMES

 

By the end of this unit, students shall be able:

  • To understand the approach to take for patients suffering from flu who require dental treatment
  • To understand the approach to take for patients suffering from rhinitis who require dental treatment
  • To understand the approach to take for patients suffering from tonsillopharyngitis who require dental treatment
  • To understand the approach to take for patients suffering from laryngitis who require dental treatment
  • To understand the approach to take for patients suffering from sinusitis who require dental treatment
  • To understand the approach to take for patients suffering from pneumonia who require dental treatment
  • To understand the approach to take for patients suffering from pulmonary tuberculosis who require dental treatment
  • To understand the approach to take for patients suffering from COPD who require dental treatment
  • To understand the approach to take for patients suffering from asthma who require dental treatment

 

UNIT 3

U.3. PATIENTS WITH HAEMATOLOGIC PATHOLOGIES

 

 

LEARNING OUTCOMES

 

By the end of this unit, students shall be able:

  • To understand the oral implications of Plummer-Vinson syndrome and its treatment
  • To understand the oral implications of anaemia and iron deficiency or megaloblastic deficiency and their treatment
  • To understand the clinical practice and dental treatment of myelodysplastic syndromes
  • To understand the oral implications of agranulocytosis and its dental treatment
  • To understand the oral implications of Thrombocytopenic Purpura and its treatment
  • To understand the oral implications of the neoplasms of the haematopoletic system and its dental implications
  • To know the vitamin K antagonists and how to handle these
  • To understand the medical interactions of coumarins and the safest drugs for anti-coagulated patients
  • To know the INR (international normalised ratio) concept
  • To understand the objective of the use of anti-coagulants and anti-platelet drugs, and when these should be used
  • To assess the risk of haemorrhaging and thromboembolism according to the type of activity or medical history of the patient
  • To understand the protocol for action for anti-coagulated and anti-platelet patients
  • To assess action for patients diagnosed with blood dyscrasia
  • To know the approach to be taken for patients with coronary stenting

 

UNIT 4

U.4. PATIENTS WITH LIVER DISEASE

 

LEARNING OUTCOMES

 

By the end of this unit, students shall be able:

  • To understand the concept of cirrhosis of the liver and the general aspects of its physiopathology that affect dental practice
  • To understand the types of hemochromatosis and the signs and symptoms that are related to dentistry
  • To assess the influence of the drugs used in dental practice on liver disease
  • To understand the concept of liver failure and the general aspects of its pathophysiology that affect dental practice
  • To assess the relationship between clotting disorders and liver activity
  • To understand the clotting mechanism: extrinsic and intrinsic
  • To understand the concept of portal hypertension and the general aspects of its pathophysiology that affect dental practice
  • To describe the digestive tract aspects related to dental practice

UNIT 5

U.5. PATIENTS WITH ENDOCRINE AND METABOLIC DISEASES

 

 

LEARNING OUTCOMES

 

By the end of this unit, students shall be able:

  • To understand what should be done and what must not be done from a dental perspective for patients with suprarenal disorders (Addison syndrome, Cushing syndrome, pheochromocytoma), thyroid conditions (Basedow-Graves disease, Hashimoto’s thyroiditis, congenital hypothyroidism), parathyroid conditions (hypo or hyper parathyroidism) and pancreatic disorders such as diabetes
  • To understand the physiopathology of suprarenal hormone production
  • To understand the physiopathology of suprarenal corticosteroid inhibition
  • To understand the guidelines for corticoid treatment in patients

UNIT 6

U.6. PATIENTS WITH KIDNEY DISEASE

 

 

LEARNING OUTCOMES

 

By the end of this unit, students shall be able:

  • To understand the functions of the kidney and the nephron
  • To understand the concept of glomerular filtration, reabsorption and tubular secretion
  • To understand the prevalence of chronic kidney disease, its causes and treatment
  • To assess the stages of kidney function pursuant to the glomerular filtration rate
  • To know the meaning of the creatinine and creatinine clearance
  • To assess the differences between the types of dialysis and the implications for dental practice
  • To understand the relationship between the immunosuppressors and their side effects for dental practice on patients with kidney transplants
  • To understand the dental problems suffered by patients with kidney disease
  • To understand the associations of kidney disease with other diseases relevant to dental practice
  • To handle the drugs and their dosage in patients with kidney disease
  • To assess the approach to take for patients with dialysis and kidney transplants

UNIT 7

U.7. PATIENTS WITH AUTOIMMUNE DISORDERS

 

LEARNING OUTCOMES

 

By the end of this unit, students shall be able:

  • To understand the main autoimmune disorders of a general nature and especially those with oral implications
  • To know the common general concepts of autoimmune diseases
  • To understand the clinical practice for erythema multiforme, and its association with external trigger agents
  • To understand other forms of autoimmune diseases triggered by external agents: Lyell syndrome. Stevens-Johnson syndrome. Behçet syndrome
  • To understand the autoimmune diseases that can involve blisters or vesicles: Pemphigus, Benign Mucous Pemphigoid
  • To understand the autoimmune diseases that can involve ulcers: Aphthous Stomatitis, Lupus, Scleroderma, Dermatomyositis, Rheumatoid Arthritis
  • To understand the clinical practice, evolution and treatment of Sjögren syndrome

 

UNIT 8

U.8. PATIENTS WITH NEURODEGENERATIVE AND PSYCHIATRIC DISORDERS

 

 

UNIT 8.1. PATIENTS WITH NEURODEGENERATIVE DISORDERS 

 

LEARNING OUTCOMES

 

By the end of this unit, students shall be able:

  • To understand the main neurological diseases and their implications for dental care: Parkinson’s, Alzheimer, Epilepsy
  • To understand the most common symptoms for neurological diseases
  • To assess the stages of neurodegenerative disorders
  • To assess the dental management index. Concept and application
  • To build appropriate treatment plans for the clinical situation and the cooperation or management of the patient
  • To understand and use the indexes which allow the assessment of the cognitive level and degree of independence of the patient, and the extent of patient cooperation: ICO, Katz, Mini-mental examination, McLeran
  • To understand the criteria to follow when treating a patient with neurological disorders
  • To assess the general framework of the clinical interview with neurological patients or their relatives
  • To understand the problems involved when performing prosthetic restorations on elderly patients with neurological conditions

 

 

UNIT 8.2. PATIENTS WITH PSYCHIATRIC CONDITIONS

 

LEARNING OUTCOMES

 

By the end of this unit, students shall be able:

  • To understand the most significant psychiatric diseases and their general clinical practice: Psychotic disorders (Schizophrenia), mood disorders (Depression, Bipolar disorders), anxiety disorders (Distress, phobias, obsessive-compulsive disorder), personality disorders
  • To understand the approach, preventative measures and treatment to follow for these conditions

 

UNIT 9

U.9. PREGNANT AND BREASTFEEDING PATIENTS

 

 

LEARNING OUTCOMES

 

By the end of this unit, students shall be able:

  • To understand the systemic modifications of pregnant women during the gestation period
  • To understand the oral changes in pregnant women
  • To understand the oral diseases related to pregnancy
  • To know the dental procedures for pregnant patients
  • To assess the stage of the gestation period to decide whether or not to perform dental treatment

 

UNIT 10

U. 10. TREATMENT UNDER SEDATION. GENERAL ANAESTHESIA

 

 

LEARNING OUTCOMES

 

By the end of this unit, students shall be able:

  • To understand general drugs and anaesthesia techniques
  • To understand drugs and conscious sedation techniques botn intravenous and nitrous oxide
  • To understand the indications and limitations of these techniques
  • To understand the risks and preventions

 

UNIT 11

U.11. MENTALLY HANDICAPPED PATIENTS

 

 

LEARNING OUTCOMES

 

By the end of this unit, students shall be able:

  • To understand how to handle mentally handicapped patients
  • To understand mental disorders and their implications for dental care
  • To understand the preventative measures to be taken

 

UNIT 12

U.12. EMERGENCIES IN THE DENTAL PRACTICE

 

 

LEARNING OUTCOMES

 

By the end of this unit, students shall be able:

  • To understand the ASA vital signs evaluation system
  • To understand how to handle variable heart rate frequency and variations in the rate and quality of the pulse in emergencies
  • To understand how to handle variations in heart rate and blood pressure when handling emergencies
  • To assess the proper wording of communication reports with other professionals
  • To understand basic life support guidelines and the management of venipuncture technique
  • To properly handle situations of vasovagal syncope, seizures, chest pains, arrhythmias, hypertensive crisis, emotional disorders, swallowing foreign bodies, breathing alterations
  • To understand allergic reactions to anaesthetics and other products and the treatment and approach to follow in these situations
  • To understand the minimum material for first aid kits

UNIT 13

U.13. DRUG INTERACTIONS

 

LEARNING OUTCOMES

 

By the end of this unit, students shall be able:

  • To understand the pharmacokinetic characteristics of bisphosphonates
  • To understand the management guidelines for patients who take or need to take bisphosphonates orally or intravenously
  • To understand the treatment guidelines for patients affected by osteonecrosis of the jaw due to bisphosphonates
  • To understand drug interaction mechanisms
  • To know the specific nature of drug use for dental practice
  • To know how to classify the drug interactions based on the seriousness and existing documentation
  • To understand the pharmacokinetics of local anaesthetics and their interactions with other drugs
  • To understand the pharmacokinetics of vasoconstrictors and their interactions with other drugs
  • To understand the pharmacokinetics of anti-infective medicines and their interactions with other drugs
  • To understand the pharmacokinetics of antifungal drugs and their interactions with other drugs
  • To understand the pharmacokinetics of glucose-lowering drugs and their interactions with other drugs
  • To understand the pharmacokinetics of NSAIDs and their interactions with other drugs

UNIT 14

U.14. PATIENTS WITH INFECTIOUS PATHOLOGIES, HEPATITIS, HIV

 

LEARNING OUTCOMES

 

By the end of this unit, students shall be able:

  • To understand the body’s defence mechanisms
  • To distinguish between the different hepatitis-producing viruses and their characteristics
  • To understand the procedures to follow for patients suffering from acute and chronic hepatitis
  • To refer contraindicated and recommended drugs for patients suffering from hepatitis
  • Approach for patients suffering from HIV
  • To understand the physiopathology and evolution of HIV
  • To understand the concepts of HIV epidemiology
  • To understand HIV-related diseases
  • To assess the risk of providing care for an HIV patient
  • To know what action to take with patients suffering from HIV
  • To understand viral load concepts
  • To understand what action to take with HIV patients
  • To understand treatment for HIV patients
  •  

UNIT 15

U.15. PATIENTS WITH CANCER CHEMOTHERAPY AND RADIOTHERAPY

 

UNIT 15.1. CANCER PATIENTS. NEOPLASMS OF THE LYMPHATIC AND HAEMATOPOIETIC SYSTEM

 

LEARNING OUTCOMES

 

o   To understand the neoplasms of the haematopoietic and lymphatic system

o   To describe the different types of leukaemia, their relationship to dental practice and their differential diagnosis

o   To describe the means of medical diagnosis of leukaemia

o   To understand the dental approach to follow for patients suffering from neoplasms of the haematopoietic and lymphatic system

o   To describe the coagulation mechanisms and the complementary tests for their assessment

o   To describe the characteristics, clinical practice and differential diagnoses of Hodgkin’s disease

o   To describe the characteristics, clinical practice and differential diagnoses of non-Hodgkin lymphoma

o   To describe the characteristics, clinical practice and differential diagnoses of Polycythemia vera

o   To describe the characteristics, clinical practice and differential diagnoses of mycosis fungoides

o   To describe the characteristics, clinical practice and differential diagnoses of macroglobulinemia

o   To describe the characteristics, clinical practice and differential diagnoses of solitary oral plasmocytoma

o   To describe the characteristics, clinical practice and differential diagnoses of multiple myeloma

 

 

UNIT 15.2. PATIENTS UNDERGOING CHEMOTHERAPHY OR RADIOTHERAPHY

 

       LEARNING OUTCOMES

 

o   To understand the consequences of mucositis, its classification and its spontaneous clinical evolution

o   To describe the risk factors of radiation-induced mucositis

o   To describe the effects of chemotherapy and the most common drugs

o   To describe the guidelines for preventing radiation-induced mucositis

o   To understand the treatment methods for mucositis

o   To describe the prevention guidelines for xerostomia in cancer patients

UNIT 16

U.16. GERIATRIC PATIENTS

 

       LEARNING OUTCOMES

 

o   To understand the differential aspects of dental backgrounds of elderly patients

o   To assess the specific features of the physiology of ageing patients

o   To understand the pharmacology of elderly patients

o   To understand the overall concepts for assessing geriatric patients

o   To assess the importance of xerostomia in elderly patients

o   To understand the preventative areas and care procedures for dental practice in elderly patients

o   To understand the care and prevention programmes for institutionalised patients

Syllabus

THEORETICAL PROGRAM
SUBJECT 1 GENERAL ASPECTS OF THE DENTAL ASSISTANCE IN PATIENTS WITH MEDICAL PATHOLOGY.
SUBJECT 2 PATIENT WITH HEPATIC AND DIGESTIVE PATHOLOGY.
SUBJECT 3 PATIENT WITH CARDIORESPIRATORY PATHOLOGY.
SUBJECT 4 PATIENT WITH METABOLIC ENDOCRINE PATHOLOGY.
SUBJECT 5 PATIENT WITH HEMATOLOGICAL PATHOLOGY.
SUBJECT 6 PATIENT WITH RENAL PATHOLOGY.
SUBJECT 7 PATIENT WITH AUTOIMMUNE PATHOLOGY.
SUBJECT 8 EMERGENCIES IN THE DENTAL CABINET.
SUBJECT 9 PATIENT WITH PSYCHIC DISABILITIES.
SUBJECT 10 DRUG INTERACTIONS.
SUBJECT 11 NEURODEGENERATIVE AND PSYCHIATRIC PATHOLOGY.
SUBJECT 12 PATIENTS IN STATE OF PREGNANCY AND BREASTFEEDING.
SUBJECT 13 TREATMENTS UNDER SEDATION OR GENERAL ANESTHESIA.
SUBJECT 14 PATIENT WITH INFECTIOUS PATHOLOGY. HEPATITIS. HIV.
SUBJECT 15 ONCOLOGICAL PATIENT. NEOPLASMS OF THE HEMATOPOIETIC SYSTEM.


PRACTICAL PROGRAM
It will be carried out in practical activity in the Primary Care Centers and in the Catalonia Foundation for Psychically Handicapped and other external institutions

Teaching and learning activities

In person



 

 Masterclasses: Topics will be presented with computer support.

Practical seminars: Attendance is compulsory. Roll call. You can only have a maximum of 2 EXCUSED absences (the documented justification will be provided at most during the week after the seminar). Clinical cases will be discussed in a participatory way Either venipuncture seminars will be held, nitros oxide management, according to the program. and then a continuous evaluation will be carried out through a computer platform in which the student needs to obtain 50% of the grade for each of the seminars in order to be able to take the practical part of the final exam. The seminar will be attended with a laptop, tablet or mobile.

Presentations:

The students, in groups, will make some presentations / communications / works that they will expose according to days and hours that will be previously specified

1. The names of the components of the groups are established in alphabetical order


2. The groups are of 5 components.

3. Erasmus students can work in team communications without the need for all members to be physically present.

4. The presentation of class work is done by one of the group members. Individual questions from the presentation will be asked to all the members of the group.

5. Obviously the Erasmus students are exempt from attending the presentation in class but at least one of the group must be able to take charge of the presentation.

6. The best communications presented may be registered at the annual SEGER congress with the tutelage of the professor.

7. Communications must be accompanied by a previous word that includes the work carried out following the established rules. The criteria for its elaboration are explained in class.

8. Teachers are available to students to answer any questions that may arise in their preparation.

9. The themes will be assigned to each group and the list with the components of the groups and the theme will be published.

10. During the last days of seminars, the papers will be presented and presented orally.

External Practices


Students will attend for 24 hours distributed between CAPs, Catalonia Foundation for the mentally handicapped and / or other EXTERNAL institutions or in the master of special patientsthroughout the academic year to complete their training, doing external internships supervised by practicing dentists in primary school or by a teacher, following an organization to be published in Moodle at the beginning of the course.

Evaluation systems and criteria

In person



MASTER CLASSES: The Exam will consist of 40 test questions with 5 answers and only one correct one. 0.20 points are subtracted for each incorrect answer.
PRACTICAL SEMINARS: The exam will consist of 10 test questions with 5 answers and only one correct one. 0.20 points are subtracted for each incorrect answer. Only those who have attended seminars that have been taught with a maximum of 2 EXCUSED absences may be examined from this part. The justification is delivered no later than the week following the absence.
The EXAM is 60% of the grade.
The grade of the communications is 10% of the grade.
The evaluation of the practical activity in the Primary Care Centers, in the Catalonia Foundation for Psychic Disabilities and other external entities is 30% of the mark.
All the parts (exam, communications and external practical activity) must be passed separately to count the final grade for the course.

 



Bibliography and resources

1. Tratamiento odontológico del paciente bajo tratamiento médico.Little JW, Falace DA Medici. Barcelona, 1998. 5ª edición.

2. Medicina interna en odontología- Tomos I y II. Rose LF, Kaye D. Salvat. Barcelona, 1992.

3. La atención odontológica en pacientes médicamente comprometidos.Bullón P, Machuca G. Laboratorios Normon, S.A. Departamento de publicaciones científicas,1996.

4. Complicaciones médicas en la consulta dental.Urraco A, Díaz MT. Litofinter impresores, 1995.

5. Urgencias médicas en la consulta de odontoestomatologíaBugarín Gonzalez R. , Galego Feal P. Lab. Menarini.

6. Emergencia Médicas en Odontología Eduardo Dias de Andrade ,Ranali José .Ed.Artes  Médicas .2004

7. Hernández M, Boj JR, Casas JI. Guía rápida del tratamiento de lasurgencias médicas en la consulta dental. Barcelona: Publicación delColegio Oficial de Odontólogos y Estomatólogos de Cataluña, 2000.

8. Myers A. Medicine 2nd edition; Harwal Publishing, 1994.

9. Tratamiento del paciente odontológica con hemopatias

Lucas Bermudo ., Palma Gomez A. Lab.Glaxo SmithKline

 

10 Medicina Interna . Farreras Rozman

 

11. Elias R. Odontología para pacientes con necesidades especiales.Madrid: Ripano EM.2008.

 

12.Fiske J, Dickinson C, Boyle C, Rafique S, Burke M. Special Care Dentistry. London: Quintessence Publishing Co. 2007.

 

13. Pinto da Silva LC, de Almeida Cruz R. Odontología para pacientes com necesidades especiais. Protocolos para o atendimento clínico. Saö-Paulo: Livraria Santos Editora.2009.

 

14. Scully C, Diz-Dios P, Kumar N. Special Care Dentistry. London: Churchill Livingstone-Elsevier. 2007.

 

15. Silvestre FJ, Plaza A. Odontología en pacientes especiales.Valencia: Publicaciones Universidad de Valencia (PUV). 2007

 

16. Odontología de alto riesgo: pacientes clínicamente comprometidos. Roberto Elías. Nº Edición:  1ª/ 2022