How should you manage a dental patient with COPD?

COPD patients generally tolerate care best with short, morning appointments (when they typically have more respiratory reserve/feel best) and a more upright (not fully supine) chair position. Nitrous oxide is generally avoided/used very cautiously in significant COPD due to risk of worsening hypoxia, and supplemental oxygen must be given cautiously in severe COPD (high-flow oxygen can suppress the hypoxic respiratory drive in some patients) rather than given routinely without caution.