Up to Date Health History

oral systemic Sep 02, 2020

Up to Date Health History

Comorbidities is something medicine and dentistry know a lot about. But in the spring of 2020 so did the general public. In 2009 an article was published in the Annals of Family Medicine specifically speaking to the definition. “Comorbidity is associated with worse health outcomes, more complex clinical management, and increased health care costs”.  The definition is the simultaneous presence of two or more chronic diseases or conditions in a patient.

Since we in dentistry are valuable healthcare providers this is an important issue in our business. According to the National Institute of aging 85% of older adults have at least one chronic health condition and 60% have at least two and 32% have between 2 and 4.  What defines older is over 50 years old. Startling is that equals to four out of every 5 older adults. Chronic diseases can include arthritis, cancer, cardiovascular disease, diabetes and depression. That is a lot of disease and the implications to the success or failure for healthcare and for dentistry is enormous not only for health but the financial burden as well. 

Placing dental implants is considered a surgery and should be taken as seriously as any other surgical procedure in the human body. The first steps in an evaluation for treatment should begin at the health history. As much as our patients may complain at the length of our documents they are necessary to be able to access our patients oral and systemic health.

Some areas that we may need to update on our forms are as follows:

Cardiovascular Health

  • Diagnosed with Cardiovascular Disease?
  • Diagnosed with High Blood Pressure? Controlled or Medicated?
  • Monitor blood pressure at home?
  • Had a Heart Attack? If yes, when?
  • Had a Stroke? If yes, when?
  • Had bypass surgery or stints? If yes, when?
  • Have AFib or history of? If yes, when?
  • Irregular Heartbeat?
  • Rheumatic Fever?
  • Implanted Device?
  • Have shortness of breath or chest pains?
  • Family history of cardiovascular disease?
  • Take anti-cholesterol medications?

Pulmonary Health

  • Do you have Asthma?
  • Do you have COPD?
  • Have you had tuberculosis?
  • Have you been diagnosed with sleep apnea? If yes, are you being treated? With what device?
  1. Do you snore? Or has someone told you that you do?
  2. Experience interruptions in breathing during sleep?
  3. Have difficulty sleeping/staying asleep?
  4. Feel tired or daytime fatigue?
  5. Family history of sleep apnea

GI/Hepatic

  • Hiatal Hernia?
  • Hepatitis A, B, C?
  • Liver disease?
  • Recurrent infection?

Neurological and Brain Health

  • History of Aneurysm? If yes, when? 
  • History of Seizures? If yes, do you take medication?
  • Do you have any paralysis? If yes, where?
  • Do you have leg pain? If yes, where?
  • Psychiatric Problems such as depression and anxiety?
  • History of epilepsy?
  • Do you have a spinal cord stimulator?
  • Been diagnosed with dementia?
  • Experience brain fog? Forget names or words? Frequently forget location of keys/phones/places/directions?

Renal/Endocrine

  • Have you had a kidney transplant? If yes, when?
  • Do you have kidney disease?
  • Are you on dialysis or have kidney failure?
  • Do you have a diabetes or prediabetes diagnosis? Type 1 or 2? Gestational? If yes, what was your latest A1C level?
  • Do you take medications for diabetes?
  • Do you have a family member with diabetes?

Orthopedic

  • Do you have any artificial replacements? If yes, what and when?
  • Do you have arthritis?
  • Do you have osteoporosis? Have you taken Fosamax, Boniva, Actonel, Reclast, Zometa, Prolia or Aredia? If yes, when and how long? When was your last dose?
  • Do you have osteopenia?
  • Have you had an abnormal bone density test? If yes, when?
  • Suspect a Vitamin D deficiency? If yes, are you taking supplements?

Cancer

  • Have a cancer diagnosis/history? If yes, what type? Current treatment?
  • Have you had radiation to the head or neck? If yes, when?
  • Have you had chemotherapy? If so, when?

Social History

  • Do you consume nicotine/tobacco? If yes, what form and how often?
  • Do you consume cannabis? If yes, what form and how often?
  • Do you chew tobacco? If yes, how often?
  • Do you have a history of alcoholism?
  • Do you have a history of an eating disorder?
  • Are you dependent on prescription or non-prescription drugs for sleep, wake or to relieve pain?

Allergies, Food Sensitivities, and Chronic Inflammatory Conditions

  • Are you allergic to latex? Eggs? Milk? Nuts? Gluten?
  • List all drug allergies
  • Have you been diagnosed with Fibromyalgia? Chronic Fatigue Syndrome?
  • Have you been diagnosed with Irritable Bowel Syndrome?
  • Do you have acid reflux? Regurgitation?

List all medications you are taking including prescription and over the counter meds, vitamins and supplements.

Implants fail for a multitude of reasons but proper planning can help  minimize early and late implant loss. Putting the time and effort in the beginning will reap rewards later.

*This is not a full health history list. Areas also to include are caries history, HIV, exercise, function/bite/TMJ Dysfunction, general anesthetic, other organ disfunction, food and drink history,