Managing the patient with severe respiratory problems

The dental management of patients with severe respiratory problems continues to be a significant challenge to the dental health care practitioner. Chronic obstructive pulmonary diseases, such as chronic bronchitis and emphysema, are the fourth leading cause of death in the United States. Asthma has increased in prevalence during the past 20 years, and the rate of death from this chronic inflammatory disease of the airways has also risen despite recent advances in medical treatments. This article will review the pathophysiology and medical treatment modalities for these chronic pulmonary diseases, as well as discuss the recognition and management of dental patients with these diseases and provide an understanding on how to avoid precipitating factors that could initiate an acute episode in the dental care setting.