Patients with chronic hepatitis—potential risks when undergoing dental surgery: Review and case report

This is a case report of a 17‐year‐old male patient with chronic autoimmune active hepatitis (CAAH) who was referred to our clinic for dental treatment prior to his undergoing liver transplant surgery. Coagulation problems and the implications of long‐term corticosteroid usage in patients with chronic hepatitis are presented. Differences in the etiology, histology, clinical features, laboratory findings, treatment, and prognosis are reviewed for the three separate but related forms of chronic hepatitis — persistent, lobular, and active hepatitis. Summary It is important to be aware of a patient's total medical picture, and how any preexisting conditions and their treatments might affect the dental care to be provided, especially in cases of invasive dental procedures. Such procedures, like any surgery of similar magnitude, have inherent risks, and the preoperative medical evaluation and postoperative care of these patients should be the same as those provided for other comparable surgeries, thus minimizing the risks of the operative procedure. In our case, the patient's condition had been previously diagnosed, and we were able to develop our treatment plan accordingly. Sometimes, though, a patient presents with problems that may be a manifestation of a more serious systemic disorder ( e.g ., bleeding gums in the absence of obvious periodontal disease). Thus, the dentist should be alert to the possible presence of other underlying medical disorders and, if any are suspected, should consult with a physician prior to undertaking elective dental procedures.