Tag Archives | tooth extraction

Bleeding After Dental Extractions in Patients on Warfarin

An interesting article titled “Postoperative Bleeding Following Dental Extractions in Patients Anticoagulated With Warfarin” written by Anthony Febbo and et al. appears in the 2016 Journal or Oral and Maxilofacial Surgery (vol. 74, pp. 1518-1523). The article sought to explore the risk of bleeding in patients on warfarin after dental extraction. Warfarin is the most common anticoagulant used in Australia which can be used to prevent life-threatening thromboembolic events, such as stroke and deep vein thrombosis from occuring in patients at risk. Varying viewing points exisist as how to best handle these patients when a tooth or teeth need to be extracted. Some options include stopping the anticoagulant before extraction or continuing to use it while local hemostatic techniques are used. However ceasing the anticoagulant could be deadly so it is not generally used. The therapeutic effect of warfarin is measured as prothrombin time and communicated as the international normalized ratio (INR) with most patients between a value of 2 and 3 for INR. Prior studies have shown a rate of bleeding after dental extraction of approximately 2 to 8% for patients on warfarin but this includes specialistic centers with highly trained dentists or oral surgeons. The authors sought to […]

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Dental Extraction Complications in Patients on Double Antiplatelet Therapy

An interesting article titled “Hemorrhagic Complications of Dental Extractions in 181 Patients Undergoing Double Antiplatelet Therapy” written by Olga Olmos-Carrasco and et al. appears in the 2015 Journal of Oral and Maxilofacial Surgery (vol. 73, pp. 203-210). The study sought to explore if dental extractions can be done safely on patients with double antiplatelet therapy. Double antiplatelet therapy is the combination of 100 mg per day of acetylsalicylic acid and a second antiplatelet agent. This type of therapy is done to prevent blood cells from forming a clot in certain types of patients who have a history of coronary artery disease, or have had a heart attack or stroke. A total of 181 patients with a mean age of roughly 67 were included in the study.  Most of the patients (76.8%) were male. A total of 217 teeth were extracted in the study which was conducted in Madrid. During the course of extraction, a total of 165 patients  had light hemorrhage which lasted less than 30 minutes. In 15 patients (8.3%) the hemorrhage continued for more than 30 minutes. After 24 hours, 162 patients reported an absence of bleeding, while 15 patients (8.3%) had light hemorrhage, and 4 patients (2.2%) […]

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How Effective is Antimicrobial Prophylaxis in Oral Procedures

An interesting article titled “Effectiveness of Antimicrobial Prophylaxis in Preventing the Spread of Infection as a Result of Oral Procedures: A Systematic Review and Meta-Analysis” appears in the 2016 Journal of Oral and Maxilofacial Surgery written by J. A. Moreno-Drada and H. A. Garcia-Perdomo (vol. 74, pp. 1313-1321). The article seeks to explore the effectiveness of prophylactic antibiotics (such as amoxicillin) for preventing localized infections of the oral cavity, neck, and thoracic cavity in patients undergoing oral procedures. Bacteremia is well known to occur after dental procedures. Severe complications as a result of infections from bacteremia have been reported. Based on expert opinions, it has been recommended that prophylaxis be given to patients at high risk before manipulation of the gingiva or periapical region of the teeth and before perforation of the oral mucosa during dental procedures. However the use of prophylactic antibiotics is controversial. In some cases this could lead to antiobiotic resistance. In the face of bacterial resistance, infections can continue to disseminate through the anatomic planes and pathways with lower resistance, leading to complications, such as Ludwig angina, thoracic empyema, septicemia, necrotizing fasciitis, cavernous sinus thrombosis, mediastinal retinitis, cerebral abscess, meningitis, and bacterial endocarditis. The study explored articles with women and men older than 18 years who underwent oral procedures and received a prophylactic antibiotic (single preoperative dose) or another intervention for the prevention of […]

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What Makes the Best Dentists?

There’s plenty of dentists to choose from and we know that finding the best one can be quite difficult. Dental health is not a matter that can be taken for granted and you need to know that your dentist will efficiently see to your needs. A good dentist will be concerned for his patients well being and will focus on it. A good dentist is also honest and won’t try and get you to buy all unnecessary dental treatments and products. After all he’s a dentist, not a salesman. You Should Feel Safe In Your Dentist’s Office: In a dentist office, it’s easy to feel vulnerable. Dentists see everything in your mouth, and regardless of what you’ve told them, they can tell how often you’re brushing, flossing and rinsing with mouthwash. When you have to undergo a procedure, from tooth extractions to implants, that feeling of vulnerability can escalate quickly. Does your dentist inspire trust and confidence from you? Do you feel safe, knowing they’ll take care of you? Any good dentist will work hard to provide an environment where you feel safe to drool from the Novocain, and where you completely trust them to perform the procedure thoroughly and correctly. […]

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Dentist Pulls Out Wrong Tooth

For anyone who has looked carefully at the complications that can happen from wisdom teeth removal page I have put together one of the complications is that the wrong tooth and even the wrong teeth can be mistakenly extracted. An unfortunate additional instance of a wrong tooth being pulled is discussed over at http://www.dailymail.co.uk/news/article-2035988/Dentist-retrieved-tooth-bin-sewed-hours-later-pulling-wrong-one.html#ixzz1Xguo9Q2tin a post titled “Dentist retrieved my tooth from bin and sewed it back two hours after pulling out wrong one” written by Stephen Moyes and Nick Constabled and published on September 11, 2011. Now for this specific case that occurs I have not heard quite anything like it. A 44 year old women in the U.K. went to see a dentist over a throbbing tooth. The dentist x-rayed her mouth and for some reason did not look at the x-ray instead extracting the tooth that the woman pointed to. The woman went home and realized that the wrong tooth had been pulled. She then went back to the dental office 2 hours later and the dentist reviewed the x-ray determined that yes the wrong tooth had been pulled, then retrieved the tooth from the medical waste bin, and sewed it back in the woman’s mouth. The […]

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