skip to main content

COPD Dental Considerations — MFDS Part 1 MCQ

Instant feedback + full explanation. One question, done properly.

ModerateHuman DiseaseCOPD Dental ConsiderationsMFDS Part 1

A 67-year-old patient with stable chronic obstructive pulmonary disease requires a dental extraction under local anaesthesia. The patient becomes breathless when the dental chair is fully reclined. Which is the most appropriate management plan?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: C — Use a more upright chair position and assess any proposed sedation carefully because respiratory reserve may be reduced

The correct answer is C. The patient's breathlessness when fully reclined is the key discriminator: treatment should be provided in a more upright position that the patient can tolerate. Sedation is not automatically contraindicated in stable COPD, but respiratory disease must inform patient assessment, technique selection and monitoring. Midazolam can cause respiratory depression; its SmPC requires special caution in impaired respiratory function and contraindicates conscious sedation in severe respiratory failure or acute respiratory depression. Stable COPD does not itself require hospital referral, antibiotic prophylaxis or avoidance of local anaesthesia. Antibiotics are indicated only for a relevant infection or another specific indication, not merely to prevent a postoperative chest infection. Inhaled bronchodilator use does not create a blanket contraindication to local anaesthetic containing a vasoconstrictor.

Reference: Devlin J. Patients with chronic obstructive pulmonary disease: management considerations for the dental team. British Dental Journal. 2014;217:235-237. https://www.sdcep.org.uk/media/iota3oqm/sdcep-conscious-sedation-guidance-unchanged-2022.pdf