Oral & Dental Management of Medical Conditions

Cardiac and stroke patients on warfarin, renal patients on dialysis, cancer patients going for chemotherapy and radiotherapy who require extractions has to be properly planned and managed. The medically qualified oral and maxillofacial surgeon will be able to coordinate dental care for the medical patient as well as manage the surgical conditions such as osteoradionecrosis after radiotherapy or osteonecrosis after bisphosphonate therapy. Dr Fan will do an assessment of the dental condition with respect to the medical illness and some times carry out a dental clearance with extractions of teeth that are beyond salvage or may potentially cause a problem eventually. Experience in this area is critical in order not to over or under treat the dental problem.

Patients with decayed teeth can be generally fine if he/she did not have other medical problems. In a diabetic patient for example, having infected areas in the jaws can make blood sugar control difficult or can potentially be very serious with massive sepsis. This applies to patients on cancer chemo or radiotherapy, liver disease or failure, renal dialysis and cardiac disease (artificial heart valves, bypass grafting). Dental clearance by removing all the decayed teeth may actually be life saving and ideally should be carried out before the start of medical treatment.