Adrenal Insufficiency and Its Implications on Dental Treatment

Adrenal insufficiency is a rare disease affecting the function of the adrenal glands leading to hormone deficiency. Medical management of these patients often consists of a scheduled regimen of hormone replacement therapies along with patient education on the management of medical emergencies, such as adrenal crisis. The primary goal of the clinician in the dental management of these patients is the minimization of stressful stimuli while being adept and equipped to manage spontaneous occurrences of adrenal crisis. Understanding the pharmacological effects and interactions of these patients' medications is also important in managing their treatment. This article outlines the underlying pathology and clinical manifestation of adrenal insufficiency and underscores specific recommendations for the medical and dental management of such patients to avoid adrenal crisis both inside and outside the clinical setting. The dentist, as one of the primary care providers for these patients, should be able to identify the physical and orofacial signs and symptoms associated with this disorder so that the patient may be diagnosed and treated as best as possible.