What complication should be monitored in patients with long-standing corticosteroid therapy during dental procedures?

In patients undergoing long-standing corticosteroid therapy, one critical complication to monitor during dental procedures is the risk of adrenal crisis. Corticosteroids are essential for certain physiological functions, and their prolonged use can suppress the body's natural production of adrenal hormones, particularly cortisol. This suppression can lead to insufficient adrenal function, especially during the stress of a dental procedure, which can cause the body to require more cortisol than it can produce.

In cases where patients are under significant stress—even minor surgical or dental interventions—the risk of adrenal crisis increases. This can manifest as symptoms like severe fatigue, confusion, nausea, vomiting, and hypotension. Therefore, it is crucial for dental practitioners to be aware of a patient's history of corticosteroid use and to assess the need for possible steroid supplementation to prevent an adrenal crisis during procedures.

Other complications may also be present in these patients, such as delayed wound healing or a risk of infection, but adrenal crisis stands out due to the acute and potentially life-threatening nature of this risk. Monitoring and managing this complication ensures patient safety during dental care.