In patients with myasthenia gravis (MG) should be guided by certain principles concerning the prevention event. worsening of the disease. This is particularly the respect for the current state of the patient with weakness in the orofaryngelal muscles and the administered drugs.
In addition to weakness in extraocular, nuchal and limb muscles often presents with impaired mimicry, weakening musculus orbicularis oculi dysphagia and slurred speech (rhinolalia, dysathria, dysphonia) may occur.
Dental treatment should be planned so that the patient take medication prior to surgery (Mestinon) about 1 -2 hour in advance, making maximum use of drug effects. These drugs (cholinesterase inhibitors) may cause some patients, excessive salivation. Patients with MG are often anxious, and therefore the investigation should take place in a peaceful atmosphere. The pre-treatment can be used anxiolytics, except benzodiazepins. Widely used local anesthetics amid type (Lidocaine, Mepivakain) should be used with caution. Procaine is contraindicated.
The inappropriate medications in patients with MG are certain antibiotics (Erythromycin, gentamicin, Neomycin, Polymyxin B, Bacitracin, Clindamycin), while no problems are given Cefalospiriny, event. Ampicillin.
Some drugs used in patients with MG showing adverse effects in the oral cavity. These include in particular cyclosporine, which is reflected in the use of gingival hyperplasia. Corticosteroids and azathioprine sometimes cause mucosal fungal infections.
Poorly fitting dentures can worsen myasthenic symptoms. Oral head during the dental operating zmírnist muscle tension and fatigue. Beneficial for patients using an electric toothbrush, which facilitates expended burden of maintaining oral hygiene.