Bronchial Asthma.
As acute attack at brochial asthma on the dental chair may require oxygen administration by O2 mask or 1/V aminophylline or salbutamol or inhalation of salbutanmol or terbutation.

COPD
Patients on bronchodilators and patients with corpulmonale may develop cardiac arrythmia due to the use of adrenaline in the local anaesthesia.

Adrenal suppression may be associated with steriod therapy.

Cystic Fibrosis
Enlargement of major salivary glands may be noted in some patients. Patients may manifest enamel hypoplasia and increased susceptibility to dental caries.

Diseases of GIT.
Some patients with duodenal ulcers may manifest thin and tortuous vessles and dilated submucosal vein near the angle of the mouth. Drugs causing irritation on the gastric mucosa such as aspirin should avoided. Anticholenergic therapy can cause xerostomia. Antacids can interfere with absorption of antibiotics. Chronic gastrointestinal tract bleeding can lead to anaemia when oral changes may be observed.

Hepatitis-A
Hepatitis A is communicable towards the end of the incubation period and few days alter the clinical manifestation of jaundice. This period usually ranges from 2 to 3 weeks.

Hepatitis-B
Dental surgical procedures can result in excessive bleeding due to prolonged prothrombin time and deficiency of platelets.
Analgesics such as non-steroidal anti-inflammatory agents should be avoided.

Renal disease – CRF and Renal Transplantation
In children with CRF, these may be growth retardation, delayed eruption, malocclusion, enamel hypoplasia, or brownish discolouration of teeth.

In immunocompromised patients oral candidiasis is seen oral infections may lead to metastatic infection.

Oral infection such as candidiasis and odontogenic infection are seen in these patients. Treatment of these infections is necessary to prevent septicaemia and metastatic infection.