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Transient Ischemic Attacks - TIA

Risks to the dental patient

Management During Treatment

  • Dental treatment could precipitate or coincide with a stroke

  • Bleeding may be increased due to medications

  • Antibiotics metronidazole and tetracyclines when taken with coumadin increase bleeding

Questions to Ask 

  • Medical consultation is required to determine the likelihood of stroke particularly if the TIA was recent 

Prevention 

  • Monitor blood pressure at each visit

  • Spot a stroke:  FAST

    • Face drooping

    • Arm weakness

    • Speech difficulty

    • Time to call 911

  • Stress reduction protocol

  • Avoid epinephrine containing retraction cord

  • Use cardiac dose of epinephrine 

References

Dental Management of the Medically Compromised Patient.  Little, Falace, Miller and Rhodus. 8th Edition

Medical Consultation Recommended 

  • When did you have the TIA?

  • What happened during the TIA?

  • Are you anxious or fearful of dental treatment?

  • What treatment?

  • How often do you see your physician?

Introduction

A transient ischemic attack is often called a "mini-stroke", but should be considered a "warning stroke".  About a third of patients who have a TIA go on to have a stroke with in a year.  A TIA, like a stroke, is caused by a clot; the only difference is that with the TIA, the blockage is transient.  A TIA lasts  form 1-5 minutes, and when it is over there is not permanent damage.

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