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Liver Disease - Oral Health Care Considerations

  • All health care workers at risk of exposure to patients’ blood and saliva should be immunized against hepatitis B virus (HBV).
  • Consult with patient’s physician to determine severity of liver disease and/or use the Child-Pugh Score or MELD Score (see also Calculators below).
  • Patients with severe liver disease may develop icterus (jaundice) Camera icon..
  • Be aware of possible hemostatic abnormalities, as well as impaired drug metabolism.
  • In patients with severe liver disease and cirrhosis, check laboratory values associated with bleeding prior to dental care.
  • Patient wih severe liver disease may also present with oral dysbiosis, which may be associated with progression to liver cirrhosis (see Mohammed H, et al. below).
  • Institution of fresh frozen plasma may be necessary before dental care for patients with severe liver disease.
  • Prior to performing any surgical procedures, be sure that the patient has not ingested any alcohol.
  • Avoid mouth rinses with a high alcohol content.
  • Do not use acetaminophen or acetaminophen-containing medications in patients with severe liver disease.
  • Check neutrophil count for patients treated with interferon. If the count is below 1,000 cells/mm3, consider antibiotic prophylaxis.

Medical Complexity Status - Liver Disease#

Liver DiseaseMCS1AMCS2C
 Drugs/ drug

See Medical Complexity Status for more information.

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