CE Course 2 - Figures

Figure 1. Amrican Society of Anesthesiology (ASA) Physical Status Classification System
(Modified to all assignment of potential risk to dental patients)
ASA I
1. normal and healthy
2. little or no anxiety
3. little or no risk
ASA II
1. mild systemic disease or a healthy ASA I with extreme anxiety
2. minimal risk during treatment
3. examples: well-controlled diabetes, epilepsy, asthma, and/or hyperthyroid or hypothyroid conditions; ASA I with upper respiratory condition, pregnancy, and/or allergies
ASA III
1. severe systemic disease that limits activitym but is not incapacitating
2. dental treatment indicated, but stress reduction protocol and other treatment modifications are indicated
3. examples: angina pectoris or myocardial infraction (MI) history, cerebrovascular accident (CVA) history, insulin dependent diabetes, congestive heart failure (CHF) with orthopnea and ankle edema, chronic obstructive pulmonary diseases (COPD) such as emphysema, chronic bronchitis, exercise asthma
ASA IV
1. incapacitating disease that is a constant threat to life
2. patient poses significant risk since he/she has a medical problem that is of greater importance than the planned dental treatment. If possible, treatment should be postponed until the medical condition has improved to at least reverted back to ASA III
3. examples: unstable angina pectoris, MI or CVA within the past 6 months, blood pressure values o 150/100 or higher, severe CHF or COPD, uncontrolled epilepsy or uncontrolled diabetes mellitus
* adapted from Stanley F. Malamed's Medical Emergencies in the Dental Office