Tooth extraction is a common dental procedure, but it becomes significantly more challenging when performed on patients with systemic conditions such as heart failure, hypertension, diabetes mellitus, and chronic kidney failure. The complexity of the procedure increases due to the unique risks and considerations associated with each systemic condition, which dentists must carefully assess. According to research conducted by the Department of Oral Surgery at the Faculty of Dentistry, Universitas Gadjah Mada (FKG UGM), proper perioperative management is key to ensuring successful outcomes for these high-risk patients.
r patients with heart failure, special attention must be given to cardiovascular function. These patients have a limited capacity to handle physical stress and hemodynamic changes during the procedure. Based on protocols developed by the FKG UGM Oral Surgery team, consultation with a cardiologist before the procedure is mandatory to determine the optimal timing and necessary modifications. The use of local anesthesia with vasoconstrictors must be carefully considered, and continuous monitoring of vital signs during the procedure is crucial.
Uncontrolled hypertension significantly increases the risk of complications during tooth extraction. Researchers at FKG UGM emphasize the importance of measuring blood pressure before, during, and after the procedure. If a patient’s blood pressure exceeds 180/110 mmHg, the procedure should be postponed until the condition stabilizes. Stress and anxiety management is also crucial, as these factors can significantly affect blood pressure levels during the procedure.
Diabetes mellitus presents additional challenges, as it can affect wound healing and increase the risk of infection. A study conducted at RSGM Prof. Soedomo FKG UGM highlights that maintaining good blood sugar control before the procedure is essential in preventing complications. The administration of prophylactic antibiotics and the use of atraumatic extraction techniques can help reduce postoperative complications.
Patients with chronic kidney failure require special considerations, including an increased risk of bleeding and a weakened immune system. Recent research from the Department of Oral Surgery at FKG UGM underscores the importance of consulting with a nephrologist to determine the optimal timing for tooth extraction, particularly for patients undergoing hemodialysis. Medication dosages must also be adjusted based on the patient's kidney function.
Comprehensive perioperative management is crucial for the success of tooth extractions in patients with complex systemic conditions. This includes thorough preoperative evaluations, procedure modifications tailored to the patient's condition, and strict monitoring during and after the procedure. The tooth extraction protocol developed by FKG UGM highlights the importance of a multidisciplinary approach involving dentists, specialist physicians, and other healthcare professionals. This initiative also supports the Sustainable Development Goals (SDGs), particularly Goal 3: Good Health and Well-being, Goal 4: Quality Education, and Goal 9: Industry, Innovation, and Infrastructure.
References:
drg. Mayu Winnie Rachmawati, M.Sc., Ph.D., Risk of Complications in Tooth Extraction Procedures for Patients with Diabetes Mellitus, https://etd.repository.ugm.ac.id/penelitian/detail/216527
Author: Rizky B. Hendrawan | Photo: Freepik
