Test Course

Adrenal crisis is a potentially life-threatening medical condition requiring immediate emergency treatment. It is a set of symptoms that indicate severe adrenal insufficiency caused by low levels of the hormone cortisol.

This module looks in detail at Addison's disease and how to manage it in the dental setting, including steroid dose adjustments for dental procedures. If you just want a quick refresher on how to manage an adrenal crisis, check out our Medical Emergencies module here.

An adrenal crisis may be triggered by:

• Infection, trauma, in fact any form of physical or mental stress (including dental treatment), in someone known to have Addison's disease or other form of primary adrenal insufficiency.
• Previously undiagnosed or untreated Primary Adrenal Insufficiency. Sometimes a crisis is the first presenting factor of Addison’s disease.
• Suddenly stopping intake of glucocorticoid medication
• Rarely, a disease process suddenly affecting adrenal function, such as bleeding from the adrenal glands caused by severe infection (Waterhouse-Friderichsen syndrome).

Dental teams should also know how to advise patients with Addison's disease about how to change their steroid dose before coming to an appointment.