J Korean Assoc Oral Maxillofac Surg.  2000 Feb;26(1):85-92.

Stress reduction protocol for proper extraction of advanced infected teeth in medically compromised patients: Review of literature & report of cases

• Yoo JH
• Choi BH
• Hong SJ
• Nam W
• Kim JB
• Yoon JH

Abstract

Common dental procedures(dental extraction & minor operation) are potentially stress-inducing in many patients, especially medically compromised patients. The body's response to dental stress involves the cardiovascular system(an increase in cardiovascular workload), the respiratory organ and the endocrine system(change in metabolism). To minimize the stress to the medical risk patient, the stress reduction protocol was established. The obtained contents were as follows: (1) Recognize the patient's degree of medical risk (2) Complete medical consultation before dental therapy (3) Schedule the patient's appointment in the morning (4) Monitor and record preoperative and postoperative vital signs (5) Use psychosedation during therapy (6) Use adequate pain control during therapy (7) Short length of appointment: do not exceed the patient's limits of tolerance (8) Follow up with postoperative pain/anxiety control (9) Telephone the higher medical risk patient later on the same day that treatment was given Though the stress reduction protocol above was applied to the dental extraction in medically compromised patients with the advanced infected teeth, the final responsibility for the complications (syncope, bleeding & infection, etc.) in a patient rests with the dentist who ultimately treats him. For the prevention of postextraction complications & poor prognosis, the authors treated the advanced infected teeth with the pulp extirpation, opening drainage through the canal and complete occlusal reduction. The final extraction and wound closure were then done after 1~2 weeks. The final prognosis was comfortable without common complications.

Keyword

medically compromised patient; endodontic drainage & extraction; stress reduction protocol

MeSH Terms

Appointments and Schedules
Dentists
Drainage
Follow-Up Studies
Hemorrhage
Humans
Prognosis
Telephone
Tooth*
Vital Signs
Wounds and Injuries