Contraindications for general anesthesia in dentistry

Indications for tooth extraction

Extirpation is done when therapeutic treatment is impossible or before prosthetics. It can be planned or emergency. It is carried out using a simple or complex method. In the first case, the dental unit is removed from the socket using forceps, and in the second, dissection of the gums, alveolar bone, and sawing of the roots into fragments may be required.

Indications for emergency surgery:

• the presence of purulent inflammation, fistula, cyst;
• acute pain that is not relieved by medication;
• fracture of the crown, root.

Planned extraction is done if:

• advanced caries, if the area of ​​the carious cavity of the crown is more than 70 percent, the pathology has spread to the root part;
• pulpitis in a complex root system, when it is impossible to properly clean the canals (usually in a figure eight);
• periodontitis with stage 3 or 4 mobility;
• third molars that interfere with neighboring ones cause changes in bite, facial asymmetry, neurological pain, pericoronitis;
• supernumerary, dystopic, impacted teeth, which cause various disorders in the dental system;
• orthodontic indications for prosthetics, installation of braces.

Experienced dentists always strive to preserve the integrity of the dentition, so radical measures are usually taken in the absence of a positive result of therapeutic treatment. After the procedure and recovery period, acute pain goes away, but chewing function worsens when removing molars or aesthetics when extracting incisors or canines.

Causes of pain in the dentition during cold symptoms

Due to the fact that in most cases, dental problems are characterized by accelerated development against the background of the presence of a cold in a weakened body, one should not forget about the possible prevailing influence of a viral infection on provoking damage to the oral cavity and the disappearance of the integrity of the dentition. After all, taking into account such features guarantees the effectiveness of possible dental treatment during a cold.

Among the most common complications noted in the performance of their function by teeth, it is customary to highlight:

the occurrence of increased pain and other discomfort occurring in the area of ​​the jaw formation, which is caused by the presence of excessive pressure in the area of ​​the nasal sinuses; Often, in order to quickly eliminate pathogenic cold symptoms and speedy recovery of the patient’s body with the possible restoration of normal well-being, the attending physician prescribes a heavy drinking regimen with the mandatory addition of drinks, the main component of which is ascorbic acid and other elements of the acid group, which, as a result of prolonged use, have the property of settling on the surface of the tooth enamel, which subsequently leads to discomfort and irritation with a feeling of teeth clenching; as a result of increased drying of the surface of the mucous membrane in the oral area with the possible presence of unremoved pieces of food and sugar residues, the development of many diseases characterized by damage to the integrity of the teeth necessarily occurs; at times, a cold acts as the root cause of the inflammatory process in the area of ​​the trigeminal nerve, which manifests itself in the form of the inability to carry out usual activities and even move in space without the presence of incessant pain in the area of ​​the jaw formation.

Anesthesia for tooth extraction

There are several types of pain relief:

• local anesthetics that are injected into the gums;
• drugs for general anesthesia injected into a vein;
• inhalation anesthesia;
• nitrous oxide sedation.

The choice of method depends on what kind of operation is being performed: simple or complex. Removing the front teeth is considered the easiest. They have one root and are easily dislocated with forceps. For pain relief, a simple “freezing” with a local anesthetic is sufficient.

Removing lower wisdom teeth is the most difficult procedure, especially if there are abnormalities in growth and location. It will require cutting the gums, cutting off part of the bone, sawing and step-by-step removal of root fragments. The operation can last more than 1 hour, so it is often performed under anesthesia.

Sedation with nitrous oxide does not exclude local anesthesia. It relaxes well, puts the patient into a state of half-asleep, and reduces fear. Often used in pediatric dentistry to remove baby teeth.

Drugs injected into a vein completely turn off consciousness for a certain period of time. The duration of anesthesia is adjusted by the dosage of the medication.

Inhalation anesthesia allows you to control the dose of the drug directly during the procedure. This ensures high-quality and safe general anesthesia and minimizes the risk of side effects.

Vaccination against covid-19 and dental treatment: are there any contraindications?

In 2022, the coronavirus pandemic is still one of humanity's main problems. New strains appear, people continue to get sick. The state is taking measures to protect citizens. One of these measures was universal vaccination against Covid-19.

The effect of coronavirus on the systems and organs of the human body has not yet been fully studied. Scientists and doctors, of course, put forward various theories, but confirming them will require years of study.

It's the same with the vaccine.

Our patients ask a lot of questions related to dental treatment during a pandemic: is it possible to come to the clinic with mild symptoms of ARVI, is it possible to start implantation after vaccination against covid-19, how will coronavirus affect rehabilitation after dental operations, and much more.

In this article, with the help of an experienced implant surgeon at our clinic, Alexey Pavlovich Nesterenko, we will try to answer several popular questions. We warn you: the conclusions are made on the basis of the general theory of medicine and the annual practice of our specialists. The doctor should make a decision about starting treatment specifically in your case after an in-person consultation and diagnosis.

→ Is it possible to come to the clinic with minor symptoms of ARVI?

No, even with minimal discomfort, we kindly ask you to postpone your appointment until the diagnosis is clarified. New strains of coronavirus can “masquerade” as a common cold. Be responsible and take care of those around you who may suffer a severe form of the disease.

→ Do I need a QR code or PCR to visit the clinic?

At the moment there are no such requirements, follow the information on our website.

→ Is it safe to visit the clinic now, or is it better to postpone treatment for now?

We comply with all the requirements of the Ministry of Health for patient safety in the clinic: temperature control, questionnaires about contact with sick people, ultraviolet disinfection lamps, disposable masks and gloves for each patient, strict control of doctors and medical staff. All our employees have undergone mandatory vaccination with Sputnik V. We care about the protection of patients and ask you to also be careful and vigilant.

→ Is it possible to have implantation if I have had coronavirus?

Can. But given the specifics of the disease and its effect on the body in moderate and severe cases, before starting dental treatment, especially for patients with chronic diseases (diabetes mellitus, oncology, pathologies of the heart and blood vessels), it is recommended to obtain opinions from related specialists.

→ Is it possible to treat teeth during vaccination?

before vaccination

It is advisable to postpone planned surgical operations (sinus lifting, bone grafting, implantation); it is also recommended not to rush into treatment after the vaccine and also wait about 2 weeks. This is due to the fact that the body receives an immune load during vaccination; during this period it is advisable not to give additional stress in the form of surgical interventions.

The exception, of course, is acute toothache and unscheduled procedures for emergency indications.

→ Will treatment for coronavirus affect the healing of implants?

In general, no. There was no trend towards implant rejection in patients who had recovered from coronavirus during the year of observation.

There is one caveat - it is not advisable to start implantation immediately after recovery if you took anticoagulants (blood thinning drugs) during the treatment period. This may affect the healing of structures in soft tissues, and there is a risk of bleeding.

→ Is it possible to remove a tooth before/after vaccination or post-COVID? What to do if you need to urgently remove a tooth and get a vaccination at the same time?

All planned removals are carried out either a week before the 1st component of the vaccine, or 2 weeks after the introduction of the 2nd component. This applies to any planned surgical intervention, be it removal, bone grafting or implantation. If it is necessary to remove a tooth due to acute pain, so as not to cause further complications, an exception is made - the causative tooth is removed at any stage of vaccination (during the break between two components, or a few days before and after).

→ Is it possible to obtain a medical exemption from vaccination if, for example, a wisdom tooth is removed or dental implantation surgery is performed?

A dental clinic cannot issue medical certificates for vaccination. But she can provide a document proving that a particular intervention has been carried out, for example, tooth extraction or a planned surgical operation. With these documents, you need to contact your general practitioner before administering the first component of the COVID-19 vaccine. If the therapist deems it necessary, he will give you a medical discharge after the surgical intervention.

→ Does treatment with anesthesia affect vaccination, can it be done after using anesthetics? Can anesthesia be given on the same day as a COVID-19 vaccine?

There is no evidence in medical practice yet that proves that anesthesia adversely affects vaccination. Regarding the administration of anesthesia immediately after vaccination, it is advisable to refrain from using anesthetics for at least a couple of days. If we are talking about acute pain, then the use of anesthesia is justified, and the surgeon or therapist uses it, while carefully monitoring the patient’s condition.

→ Is it possible to get vaccinated against coronavirus if you have periodontitis?

Yes, you can, periodontitis is not a contraindication to vaccination.

→ If your teeth hurt, can you get vaccinated against Covid?

If your teeth hurt, you need to go to a dental clinic to eliminate the cause of the pain. The dentist will issue a document stating that a certain intervention was performed (treatment, depulpation, removal, etc.), and with this document you can contact the therapist before the first component of the vaccine. If the therapist considers it necessary to give medical withdrawal for a certain time, then, accordingly, it is advisable to postpone the vaccination.

If you have any questions about this topic, please contact us by phone numbers listed on the website or by mail

Expert of the article Alexey Pavlovich Nesterenko Implant surgeon

Experience more than 10 years

Stages of the procedure

Simple extirpation is carried out using forceps, consisting of cheeks, a handle, and a lock. It is performed if the coronal part is well preserved and there are no various complications. Incisors and canines on the upper jaw are removed with straight forceps, on the lower jaw - curved at an angle of 90 degrees. S-shaped instruments are used to extract premolars and molars.

Removing an upper wisdom tooth is easier than on the lower jaw, since it has an even, small root, so a simple operation is performed if there are no complications. The lower jaw bone is denser and more massive, and the root part of the figure eight is complex.

A simple extraction consists of several steps:

1. local anesthesia;
2. antiseptic treatment;
3. application of forceps followed by advancement of the cheeks under the gums and fixation;
4. rocking, dislocation and extraction of a dental unit from the socket.

Complex extirpation requires the use of several different instruments, takes a longer time, injures nearby tissues, is dangerous for complications, and the rehabilitation process lasts longer. Pain relief during tooth extraction, especially eights, can be general. The surgeon uses a scalpel or laser, drill, elevator, excavator, and other instruments.

Step-by-step complex removal:

• local or general anesthesia;
• antiseptic treatment;
• dissection of the gums, separation of the flap from dental and bone tissues;
• if necessary, drilling or cutting off part of the bone, dividing the root into several fragments;
• extraction of a dental unit in whole or in parts;
• bleeding stop;
• application of antibacterial and anti-inflammatory drugs;
• suturing the gum.

To stitch soft tissues, self-absorbing or non-absorbable threads are used, which are removed after 7-10 days.

Urgent cases of depulpation

Urgent cases of tooth extraction, despite a cold in the body, include all types of fluxes, when the danger of their development prevails over the danger of an inflammatory condition.

The dentist may refuse to remove a tooth if there are herpes sores on the lips, around the line of the mouth, and along the lower edge of the nose. The infection that causes herpes is stronger than cold viruses, and dentists are rightfully wary of it.

During a cold, the body fights germs and infections, which significantly weakens the strength of its immunity. Therefore, the risk of infection of open wounds that appear after dental surgery increases. Here the doctor makes a fundamental decision about what is more important for health – tooth extraction or eliminating problems with colds.

An important argument for postponing tooth extraction due to a cold is the use of anesthetics and painkillers during pulp removal, which can have a bad effect on a person weakened by a cold.

Possible complications

When using an elevator, an adjacent molar or premolar may be displaced or even broken. In the upper jaw, it is possible to push a fragment into the maxillary sinus. Fractures of the lower jaw are very rare.

Immediately after surgery, swelling occurs, and after the anesthetic wears off, pain occurs. Such phenomena disappear within one or several days, depending on the complexity of the procedure performed. Temporary numbness of soft tissues in the operated area, increased temperature, and bleeding are possible.

Pus in the hole after tooth extraction appears due to alveolitis. When a blood clot, which protects against the entry of bacteria and food, falls out of the socket, the pain intensifies and inflammation develops. In this case, you need to contact the doctor who performed the operation.

Can you treat your teeth if you have a sore throat?

A sore throat is a rather unpleasant thing in itself. It is a symptom that not everything is in order with our throat and health in general. This can be a common cold or tonsillitis, which can be caused by various pathogens, namely viruses, bacteria and fungi. Often a sore throat does not go away long enough. It interferes with living, working, studying, and relaxing normally. This condition cannot be ignored; you must urgently seek help from a doctor who will prescribe adequate treatment.

What to do if, in addition to a cold and sore throat, toothache is added and there is an urgent need to visit the dentist? Or is it your turn to see a doctor by appointment? Can you treat your teeth if you have a sore throat?

Of course, treatment of diseased teeth is possible, but only in cases where the patient simply cannot bear the pain. However, dentists in most cases recommend postponing the procedure until complete recovery.

There are many reasons for refusing to carry out the procedure and postponing it to a “healthier day”:

Firstly, during a cold, the body is a source of infection, the body becomes weak and vulnerable, therefore the risk of developing complications, stomatitis, fluxes, etc. increases;

Secondly, the patient takes various medications - antiseptics, antihistamines, antibiotics, which do not combine well with dental treatment using painkillers;

Thirdly, when a person is sick, he has difficulty breathing - a runny nose and nasal congestion appear, which forces him to breathe through his mouth. In addition, constant sneezing and coughing will interfere with the procedure.

When going to the dentist with a sore throat, think not only about yourself, but also about him. After all, he is unlikely to be pleased with your cough and runny nose. In addition, he simply can become infected from you, and then his colleagues and family will catch the disease. Therefore, it is still better to overcome the disease first, and then go to the doctor.

Sometimes small children find themselves in a similar situation and are very difficult to persuade to undergo dental treatment. What to do in such a situation? The answer is simple - you need to find a good dental clinic for children, where they will go without hysterics and with pleasure. This is exactly what the Amistom children's clinic is https://amistom. ru/detskaya-stranichka, where children's teeth are treated without pain and fear.

Care instructions

Before the socket is tightened, you should not overheat the body, drink or eat hot or cold drinks, food, or chew on the operated side. You should not smoke, as nicotine constricts blood vessels and impairs wound healing. It is forbidden to lick a blood clot from the socket.

Antibiotics are prescribed for tooth extraction if the procedure was complicated. They are necessary to prevent tissue infection and the development of inflammatory processes. For the same reason, it is recommended to rinse your mouth with antiseptics. In this case, there is no need to rinse intensively, since it is possible to wash out the blood clot from the socket. Analgesics can be used to relieve pain.

Is it possible to treat teeth with a runny nose?

During the period of colds, the human body becomes vulnerable to external irritants. The logical conclusion follows from this that any dental procedures will harm an already weakened body.

In addition to general weakness, there are also several reasons why a visit to the doctor should be postponed even if your health has improved slightly:

the possibility of pathogenic microflora entering the body as a result of weakened immunity; a dental procedure can cause open wounds in the mouth through which infection can enter the body; taking analgesics can negatively affect the body affected by the virus; a person with a runny nose will not be able to stay in the dentist’s chair for a long time.

In addition to the above arguments, there is also the possibility that the patient can infect the dentist and nearby people. Everyone decides for themselves whether to go to the dentist or not during such a period, however, first of all, you need to focus on curing the underlying disease.

Despite this, having a cold does not prohibit you from visiting the dentist. The decision must be made based on your own state and feelings. If you have a strong fever, aches and general weakness, a trip to the dentist should be postponed until the condition improves.

In some situations, specialist help is required immediately. For example, acute toothache can cause illness. This also applies to periodontitis, gumboil, in which there is significant swelling of the cheek. In any case, the question of the need to remove a tooth should be decided together with a therapist and dentist.

FAQ

• Is it painful to remove a tooth?

Painless tooth extraction using local anesthetics is carried out by absolutely all dental clinics. But if “freezing” is not enough, then it is better to go to a private clinic that provides all types of pain relief.

• How do you know when a tooth needs to be removed?

If it is very loose or the crown is completely destroyed, then most likely it will be removed. In other cases, accurate diagnosis is necessary.

• Is it possible to have a tooth removed if you have a cold?

Surgical intervention is unacceptable in the presence of an acute infection, including acute respiratory infections or influenza. This is due to the high probability of infection of injured tissues.

• Is it possible to remove a tooth if you have sinusitis?

The operation is not performed during exacerbation of the disease.

Is it possible to treat teeth at fever?

Alina Kalashnik

Well, it's up to you to decide

If the temperature continues tomorrow, refuse

Definitely - NO! Out of respect for the doctor, because there is a risk of transmission of infection. And it’s not very good for yourself, you can add a couple of extra viruses to the existing ones, and aggravate the situation.

Apricot pie

Have pity on the doctor. Better call and warn.

SAD EYES.

No. You can get an infection in the wound.

Astafieva Yulia

You know, it's kind of a double-edged sword. What if a person needs to go to work and takes one day off? You’d better get a good treatment, after all, 37.5 is not such a high temperature, and you’re still at the very beginning. If you still doubt whether to go or not, then ask your dentists how best to proceed. There are online consultations here and on sites such as 32 TOP-ru. By the way, there is a very good list of Moscow dentists, with all the data, addresses, telephone numbers. And there are reviews, so if you are from Moscow and don’t get to your clinic, you can always choose another one.