I had gallbladder surgery last year and I have an upcoming one this year for my thyroid but I was wondering, why is it that they ask about dental stuff. Why is it important for surgery? What happens to people who have emergency situations and have like bad teeth or something? Just curious.
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Anesthesiologist here.
It’s so we can avoid damaging teeth when placing a breathing tube. The state of the teeth is really irrelevant to us doing the case. We just care that we know the baseline and can document it and then avoid making it worse. An accidentally dislodged tooth can easily go into the airway.
For some surgeries where they implant foreign hardware (like heart valves or hips) they want teeth that are infected to be pulled to avoid infection spreading to that hard to remove implant.
A dental infection or abscess can cause bacteria to enter the bloodstream, and settle in surgical areas, so it can represent additional risk. For an elective surgery, they can have you get the dental issues fixed, or prescribe antibiotics.
For an emergency surgery, they just do the surgery, then monitor for signs on infection. It may represent additional risk, but if the surgery is more important, they are willing to take that risk if it cannot be avoided.
Not for gall bladder necessarily, but I am frequently ask to give “dental clearance” for specific medical procedures. Most often for radiotherapy to the head/neck for cancer treatment. There are several treatments that can lead to bone necrosis following dental surgery. Extractions after radiation treatment, bisphosphonate and denosumab administration increase the risk. Google: osteoradionecrosis and MRONJ. It’s fucking scary.
Hey! Someone in the same boat. There are several reasons. I’m getting ready to have heart surgery and the most *likely* place for bacteria to enter your blood stream is through open wounds, and there are no easier places (because of the moisture and heat) for bacteria to enter into your bloodstream than your mouth.
Back-up: Dentures, crowns, bridges, etc., can all impact intubation as well. Some older implants/dentures/crowns may also be made of *just* enough magnetic material to be problematic in MRIs, as well.
Fun fact: I had to shell out $6000 for dental surgery before having the pleasure of shelling out $7500 (out of pocket max) for heart surgery. The magic bones in your face not covered by your medical insurance have to be fixed before a surgeon will work on the parts of you that ARE covered by medical insurance.
Side note: Dental care is not expensive. Dental neglect is.
Before they knew to give antibiotics for long, deep dental procedures, too many folks died afterwards. Doctors finally learned that people died because the germs settle in the heart. That’s what killed my oldest cousin and my best friend.
They both were losing their insurance soon and thought it would be a good idea to get a lot of work done. Healthcare in the US has always sucked.
The top answers touched on the most common reason, intubation. I have another specific and interesting reason.
My father received a lung transplant and they wouldn’t put him on the donor list until he had a couple of messed up teeth extracted.
Organ transplant recipients need to have their entire immune systems suppressed so their body doesn’t reject the new organ. An infected tooth while you have no immune system could become a serious problem.
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