Does this scenario sound familiar? Your patient checks the appropriate box on your medical history that says “asthma”. Now what to do with the information. The most important information you will need to extract from this positive response is the level of the patient’s knowledge about their asthma, the degree of control of asthma attacks and the most serious consequence of their asthma. First, ask your patient what elicits an asthma attack. Many patients will report they haven’t had an attack since childhood. Childhood asthma are often caused by exercise, stress, illness, weather (cold) and allergens. Many children do “outgrow” their asthma, especially in response to exercise. Second, determine how your patient controls their attacks. The two primary answers will be medication or an inhaler. Spend a moment and allow the patient to explain their use of medication or inhaler. Third, if your patient uses an inhaler, ask when it was replaced last. Remind the patient to keep a current inhaler with them. Many patients keep an inhaler in the car. Inhalers should not be kept in the car due to heat.
After asking these type of questions, focus on your dental treatment. Ask specifically if they have had an attack due to stress, cold air and dehydration. If these are causative factors for them, stress reduction protocols are in order. Suggestions: morning appointments, sedation, nitrous oxide. If cold air (weather) is a trigger for them, remind your assistant to use high-speed aspiration during treatment. Please be certain you have your in-office inhaler in the operatory when you perform treatment. For more information on asthma and any other in-office medical emergency, please visit my website for additional education resources.