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12 types of medical history that must be confessed to the dentist before tooth extraction!
Event: Angina pectoris after a tooth extraction in a patient with a heart disease. The 65-year-old Uncle Li had a severe toothache. He was eager to extract a tooth and concealed his history of heart disease from the doctor. After the tooth extraction, he induced angina pectoris and a short-term cerebral circulatory disorder. After the doctor rescued him, he was out of danger.
Reminder: The current doctor-patient relationship is particularly tense, and doctors are working like walking on thin ice. And tooth extraction, as a treatment item that is prone to accidents in dental treatment, is largely related to the patient’s incomplete dentistry cognition and eagerness to seek treatment.
Therefore, it is very important to tell the truth about your physical condition before tooth extraction. Do not hide your medical history, otherwise you may threaten your health. The doctor will decide whether to perform a tooth extraction operation or make corresponding preparations based on the patient’s health status and medical history, such as the choice of anesthetics, whether the tooth extraction needs to be performed under ECG monitoring, and so on.
1. Menstrual women
In principle, women should avoid tooth extraction during menstruation, because compensatory bleeding may occur in the alveolar during menstruation. But pulling out a loose tooth during menstruation has little effect on the patient. Some “deep-rooted” teeth, such as impacted teeth or impacted teeth, should be removed after menstruation. According to data, it is most suitable for women to extract their teeth on the 10th day of the menstrual cycle. At this time, the wounds heal faster and bacterial infections are less likely to occur.
2. Women during pregnancy
Some people think that tooth extraction is not allowed during pregnancy because it may cause miscarriage. However, a large number of clinical practices have shown that tooth extraction is safer in 3-7 months of pregnancy and has no adverse effects on pregnancy. During this period of tooth extraction, you should also pay attention to the following points:
① 10 mg of progesterone was injected intramuscularly on the day before and on the day of tooth extraction.
② Adrenaline should not be added to tooth extraction anesthetics.
③The anesthesia must be complete and the analgesic effect is better. For patients with a history of habitual miscarriage or habitual preterm birth, tooth extraction is prohibited during pregnancy.
3. Patients with cardiovascular disease
There are serious cardiovascular diseases and hypertension above 180/100 mmHg. Ordinary heart disease patients, as long as there is no manifestation of cardiac insufficiency (such as light activity or palpitation and shortness of breath when lying supine), teeth can be extracted. However, it should be done during tooth extraction: do not add epinephrine to the anesthetic to avoid tachycardia and induce heart failure; complete anesthesia and light movements to minimize adverse irritation, bleeding or injury; anti-infection prevention treatment should be given before and after tooth extraction, because the heart The disease patient’s resistance is reduced, and it is more likely to be infected with it than normal people.
4. Patients with hypertension
Bleeding diseases: For example, patients with hemophilia and primary thrombocytopenic purpura have obstacles in the blood coagulation process in the body, so they have a bleeding tendency. Bleeding is difficult to stop after tooth extraction, which can cause heavy bleeding and life-threatening. In leukemia patients, because they are very prone to infection, the wound after tooth extraction can also become a focal point of infection, leading to serious systemic infections that are difficult to control. Therefore, when these patients suffer from dental disease, they should be treated conservatively and tooth extraction is contraindicated.
5. Diabetics
Diabetes patients are prone to infections after the operation due to reduced resistance. For those with severe disease, tooth extraction should be postponed. For those who must extract the tooth, please consult a physician. Take medication for several weeks before the operation to control blood sugar stability (generally, the indication for tooth extraction requires blood sugar to be controlled below 8.88mmol/L). Antibiotics should be used before and after tooth extraction to prevent concurrent infection.
6. Patients with liver and kidney disease
For patients with acute hepatitis or severe liver damage, tooth extraction should be delayed, because this type of liver disease can be caused by a deficiency of prothrombin and fibrin, or the liver’s inability to use vitamin K to synthesize related blood coagulation factors, resulting in continuous bleeding after surgery. You must wait for the disease After getting better, perform tooth extraction again. Supplement appropriate amount of vitamin K to these patients before surgery to promote the synthesis of prothrombin to supplement the deficiency of fibrinogen and avoid accidents.
People with severe renal impairment should not extract teeth to avoid renal failure. Generally speaking, those with mild kidney disease should inject antibiotics before tooth extraction to prevent temporary bacteremia caused by tooth extraction and promote acute onset of kidney disease.
7. Hyperthyroidism
Such patients can cause thyroid crisis due to infection, surgery, and anxiety. In severe cases, it can cause failure or even death, so it is not advisable to extract teeth rashly. If it is necessary to extract a tooth, a detailed examination should be performed to make its basic metabolism below +20%, pulse rate below 100 beats per minute, no adrenaline vasoconstrictor in anesthetics, and antibiotics should be taken before and after surgery.
8. Patients with acute infectious diseases
Pernicious anemia, severe tuberculosis, malnutrition, and excessive fatigue can reduce the body’s resistance, delay wound healing, and cause infection. Therefore, tooth extraction should be delayed.
9. Patients with organic and functional neurological diseases
Patients with this disease should consider the possibility of the onset of disease during and after the operation. If the tooth must be extracted, the operation should be performed after the neurologist’s consultation and treatment, and sedatives should be given before the operation.
10. Patients receiving radiotherapy
It is not advisable to extract teeth during radiotherapy and within one year after the end of the treatment to avoid causing radiation osteomyelitis. Antibiotics should be used to prevent postoperative infections when tooth extraction is necessary after one year of radiotherapy.
11. Patients whose teeth are located in the area of malignant tumors
It is contraindicated to extract the tooth alone, but should be removed in one piece together with the affected tooth at the same time as the tumor is removed. Therefore, if there is a long-lasting ulcer in the affected tooth area, a biopsy should be taken for the tumor first to exclude the malignant tumor before extracting the tooth.
12. Patients with blood diseases
Patients with blood diseases such as hemophilia, leukemia, aplastic anemia, thrombocytopenic purpura, and scurvy, if they have a tooth extraction, they are likely to suffer from inadequate blood flow after surgery due to insufficient self-clotting function. Therefore, it is necessary to Avoid tooth extraction. For those with a long-term history of anemia and self-reported daily status, they should undergo routine blood examinations depending on the specific situation. Generally, those with hemoglobin above 80g/L (8g/dl) can extract their teeth.
The best time to extract the tooth (morning or afternoon?):
Tooth extraction is not about pulling out whenever and wherever you want, you must pay attention to “time, place, and harmony”. It is safer to choose the morning extraction. Try to avoid the afternoon extraction, because if there is discomfort such as bleeding after the extraction, it is better to seek a doctor’s treatment in time. Prevent inconvenience in handling special circumstances at night. Patients with tooth extractions in the morning should ensure the quality of breakfast and avoid tooth extractions on an empty stomach to avoid hypoglycemia due to tension. You also need to have plenty of energy and physical strength before tooth extraction. For example, you should avoid tooth extraction when you just stay up late, just after a long trip, or after being overworked.
Precautions after tooth extraction
The end of the tooth extraction does not mean that the problem in the oral cavity is also over. Bleeding and infection are most likely to occur after tooth extraction, so there are many details that need to be understood and mastered:
1.Do not gargle or eat within 2 hours after tooth extraction, do not lick the wound with your tongue, and do not touch the wound with your fingers, so as to avoid re-bleeding or secondary infection.
2. Bite a cotton ball or gauze ball to stop bleeding. Too much force will cause severe pain; too light or too short time is not conducive to hemostasis; too long, after the saliva soaks the cotton yarn, it is easy to be infected. Therefore, it is best to bite for 30-40 minutes before spitting out.
3. Tooth extraction is a traumatic operation. After the operation, you should pay attention to rest, talk less, do not do strenuous exercise or heavy physical labor, do not smoke or drink, so as not to aggravate the pain and prolong the healing period of the wound.
4.Avoid brushing your teeth on the day of tooth extraction to avoid bleeding from solidified wounds. Use mild mouthwash or light salt water to rinse your mouth. At the same time, avoid eating hot or too hard and spicy foods. You can eat more vitamin-rich fruit juice or fruit puree. To supplement nutrition and promote wound healing.
Experts remind:
It is normal to have slight pain within 24 hours after tooth extraction. It is normal to have some pink blood or blood in the saliva. You can take an appropriate amount of anti-inflammatory and analgesic under the guidance of a doctor. But it is worth noting that the pain and bleeding should be getting lighter and less. If there is continuous bleeding or pain after a few days, or even obvious uncomfortable symptoms such as dizziness, palpitation, etc., you should go to the hospital for follow-up treatment immediately after finding the cause.
When choosing a tooth extraction, the extracted deciduous teeth or wisdom teeth are still of great use. If your teeth are healthy, the extracted teeth can also be used to store dental pulp stem cells to prepare a health guarantee for the future. Patients suffering from disease should carefully explain to the doctor before tooth extraction. The doctor will decide whether to extract the tooth or make preparations according to the specific situation. Concealing the condition and rushing to extract the tooth can sometimes cause serious adverse consequences.