Anemia

Quita, Jeshyle G.
DMD 3AA

Anemia

It is a medical condition in which there is a decrease in number of red blood cells (RBCs) or less than the normal quantity of hemoglobin in the blood. For men , anemia is typically defined as hemoglobin level of less than 13.5 gram/100 ml and in women as hemoglobin of less than 12.0 gram/100 ml.

Anemia
most common disorder of the blood. It is caused by either a decrease in production of red blood cells or hemoglobin, or an increase in loss or destruction of red blood cells.

What causes Anemia?

The three main causes of anemia are: Blood loss Lack of red blood cell production High rates of red blood cell destruction
It may be classified as impaired red blood cell (RBC) production, increased RBC destruction (hemolytic anemias), blood loss and fluid overload (hypervolemia). the most common cause of anemia is blood loss, but this usually does not cause any lasting symptoms unless a relatively impaired RBC production develops

Blood Loss
Blood loss is the most common cause of anemia, especially iron-deficiency anemia. Blood loss can be short term or persist over time. Heavy menstrual periods or bleeding in the digestive or urinary tract can cause blood loss. Surgery, trauma, or cancer also can cause blood loss. If a lot of blood is lost, the body may lose enough red blood cells to cause anemia.

Lack of Red Blood Cell Production

Acquired conditions and factors that can lead to anemia include: poor diet abnormal hormone levels, some chronic (ongoing) diseases pregnancy

Aplastic Anemia
It can prevent your body from making enough red blood cells. This condition can be acquired or inherited.

Some infants are born without the ability to make enough red blood cells.
Acquired conditions or factors, such as certain medicines, toxins, and infectious diseases, also can cause aplastic anemia.

High Rates of Red Blood Cell Destruction

It is acquired and inherited conditions and factors can cause your body to destroy too many red blood cells. One example of an acquired condition is an enlarged or diseased spleen.

High Rates of Red Blood Cell Destruction

The spleen is an organ that removes wornout red blood cells from the body. If the spleen is enlarged or diseased, it may remove more red blood cells than normal, causing anemia. Examples of inherited conditions that can cause your body to destroy too many red blood cells include sickle cell anemia, thalassemias, and lack of certain enzymes.

Signs & Symptoms

There has no symptoms if the anemia is mild. . If the problem develops slowly, symptoms that may occur first include:

Weakness or fatigue general malaise sometimes poor concentration Dyspnea (shortness of breath) on exertion Feeling grumpy Headaches

Signs & Symptoms

If the anemia gets worse, symptoms may include: Blue color to the whites of the eyes Brittle nails Light-headedness when you stand up Pale skin color Shortness of breath Sore tongue

In severe anemia
There may be signs of a hyperdynamic circulation tachycardia (a fast heart rate) bounding pulse flow murmurs cardiac ventricular hypertrophy (enlargement) There may be signs of heart failure

Dental Management
Anemia & anesthetics
MILD ANEMIA Use lidocaine with epinephrine, maximum of 2 carpules MODERATE ANEMIA Use bupivacaine with 1:200,000 epinephrine for major procedures and Mepivacaine without epinephrine for minor procedures SEVERE ANEMIA Defer dental rx til the patient is stabilized

Dental Management
NOTE:
Use Mepivacaine without epinephrine ONLY for ALL procedures with G6PD anemia AVOID PRILOCAINE AND SEPTOCAINE with all anemias

Dental Management
Anemia & Analgesics
No aspirin / NSAIDS: Platelet dysfunction, Gastritis and Acidosis

Anemia & Antibiotics

Safe to use: Penicillins Trimetrophim and Sulphamethoxazole is not an affective antibiotic for oral infections

Dental Management
Anemia & Antibiotics
Diazepam depresses the respiratory center Use antibiotics to prevent/ treat infections & promote healing Control pain with Acetaminophen with or without codeine Avoid aspirin/ NSAIDS as they promote bleeding

Thank You for Listening!!!