Pre-Existing Medical Conditions and Your Oral Surgery: What to Know

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Before any minor or major oral surgery procedure, such as wisdom teeth extraction, extraction of non-restorable teeth and grafting the site with bone, placement of dental implants, oral surgical procedures to aid orthodontic treatment, jaw surgery for fracture of facial bones or reconstruction of jaw deformities, your oral surgeon will provide you with a treatment plan that outlines the procedure that will be done, the type of anesthesia that will be used, and post-procedure recovery and follow-up. During this time, you should also inform them about any pre-existing medical conditions you may have as these conditions may impact the surgical procedure, the anesthesia, recovery and outcomes.

Some medical conditions, medications, drugs and/or herbal supplements that you take (over the counter, prescription, or recreational) can affect not only your overall health, but your oral health as well. They can also affect the outcomes of any procedure you undergo and the anesthetic you receive for the procedure. It is for this reason that your oral surgeon will ask you about your medical and medication history before any treatment or procedure takes place and it is critical to give him/her detailed and accurate information.

Here are some common pre-existing medical conditions that can affect oral surgery:

Diabetes
Over 34.2 million people in the United States have diabetes, and roughly 7.3 million have not been officially diagnosed. Managing diabetes is essential before any oral surgical procedures are performed. People who have poorly controlled diabetes are at an increased risk of infection.

The stress associated with surgery can make it harder to control blood sugar levels and complications can arise during the surgery and sedation for the procedure. Additionally, you can be at an increased risk of developing infections and healing slowly if your diabetes is not well controlled. Speaking with your oral surgeon can help them devise an appropriate and safe plan for your surgery and anesthetic before the appointment. Your surgeon will also give you specific instructions about your diabetes medications if you are being sedated for the procedure. Sedation or anesthesia requires patients to be fasting for 8 hour prior to the scheduled procedure, and taking your diabetes medication while fasting can precipitously drop your blood sugar levels and result in a medical emergency.

Heart Disease Complications
Heart disease can include conditions like hypertension, coronary artery disease, abnormal heart rhythms, heart failure, leakage of heart valves to name but a few. There are several precautions that must be taken while preparing for oral surgery depending on the underlying heart problem. People who have had a previous stroke or heart attack may be at an increased risk of having these conditions again due to the inflammation that occurs during or after the surgery. Additionally, if you are taking blood thinners (anticoagulants), the medication can cause excessive bleeding during oral surgery. Your oral surgeon will discuss the procedure to be performed and the anesthesia with your cardiologist beforehand to minimize your risk and optimize your heart health to reduce medical complications. The surgery room and staff will be prepared as your treatment and potential complications are reviewed by the team prior to the procedure in case you experience a medical emergency during surgery.

Chronic Obstructive Pulmonary Disease (COPD)
Chronic obstructive pulmonary disease (COPD) represents a group of chronic lung diseases that can include emphysema and chronic bronchitis. This disease can create long term damage to the lungs and you may experience uncontrolled wheezing and coughing. When undergoing oral surgery under intravenous anesthesia, you may experience an increased risk of obstructed airflow that can further aggravate these medical symptoms.

Obtaining a preoperative examination and discussion with your pulmonary doctor beforehand will allow the oral surgeon and his/her team to devise a plan that minimizes risk of bronchospasm and/or laryngospasm which are medical emergencies that can have serious consequences. The oral surgeon in consultation with your pulmonary doctor will recommend the right time when you should have the surgery in an effort to minimize complications.

Other Medical Conditions 
The severity of any pre-existing medical conditions is irrelevant - you should tell your oral surgeon about them regardless. Asthma, HIV, eating disorders, pregnancy, allergies – seasonal and to medications, epilepsy, kidney disease, cancer and more. Any and all pre-existing medical conditions are important to mention, as well as any over-the-counter, prescription, recreational drugs and supplements that you take. 

You should never put off your oral health if you have a pre-existing medical condition. Instead, getting a consultation with your doctor and oral surgeon can help devise the best care plan to ensure that you can completely recover from the oral surgery.

For more information about oral surgeries, contact Northwest Oral and Maxillofacial Surgery to meet with one of our eight* Board Certified surgeons.

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