Evaluation of the medical history.

Medical and dental interdisciplinary cooperation is critical in appropriate assessment of the medical history and the subsequent management of the medically compromised dental patient. This interdisciplinary, rather than multidisciplinary, cooperation must extend beyond the physician and include the patient, family, caregivers, therapists, and anyone else involved in the life of the particular individual. This article has discussed numerous medically compromising conditions that require cooperative efforts between dental health professionals and other health care professionals. Specific recommendations were made regarding certain medical problems that affect dental care. The patient with a medical condition has a significant disability affecting many facets of life, essentially no different than a person with a physical or mental disability. The critical activity on the part of the dentist in managing the medically compromised dental patient is the cognitive skill ability. Cognitive skills permit appropriate use of the proper technique and behavioral skills. Proper oral health care can contribute significantly to a person's quantity and quality of life. The concept of optimum dental treatment planning differs from ideal dental treatment planning but should not be considered compromised dental treatment planning. Finally, an evaluation tool, the DRAPE Scale, is a means to aid dental treatment planning for the medically compromised dental patient. Remember that optimum care may not be ideal and is influenced by patient-specific and situation-specific circumstances. When this approach to treatment is followed in the appropriate interdisciplinary fashion, the patient benefits, and an individual's quantity and quality of life should benefit. Dental care for the patient with medically compromising conditions can be difficult and infinitely challenging but ultimately rewarding.