Can My Stroke-Affected Mom Safely Undergo Tooth Extraction?

Mother had a stroke, is paralyzed, requires a tracheostomy, and needs to have teeth extracted?

My mother has been paralyzed and on a tracheostomy for a year due to a stroke.
Initially, she was in a coma and had to undergo intubation, which resulted in the loss of several teeth.
Currently, she has 3 to 4 loose and misaligned teeth, and we would like to have them extracted.
We previously visited Wuchi Children's General Dental Clinic, but the doctor did not agree to the extractions due to my mother's health condition at that time.
Now that she is awake and conscious, we are concerned because her teeth are causing bleeding and pain.
I would like to ask if her condition is suitable for tooth extraction.
Additionally, since my mother has limited mobility and it is not feasible for us to visit multiple hospitals for consultations, could you please advise which hospital would be the most appropriate for her to ensure a successful tooth extraction?

Shian, 30~39 year old female. Ask Date: 2007/10/14

Dr. Wu Jinjun reply Dentistry

Hello, based on your description, your mother's loose and misaligned tooth may need to be extracted.
First, confirm whether she is taking anticoagulants (as most stroke patients do).
If she is on such medication, it must be stopped prior to the extraction.
Hospitals at the regional level and above should have the capability to handle this.
If you are located in Taichung, you can consider options such as Chung Shan Medical University Hospital, China Medical University Hospital, or Taichung Hospital.
Dr.
Yang Zhiren from the Dental Department at Hsinchu Hospital, Department of Health, Executive Yuan.

Reply Date: 2007/10/14

More Info

When considering whether your stroke-affected mother can safely undergo tooth extraction, several factors must be taken into account, particularly her overall health status, the specific condition of her teeth, and the potential risks associated with the procedure.

Firstly, it is essential to understand that stroke survivors may have various complications that could affect their dental care. These can include issues related to mobility, swallowing, and the ability to communicate discomfort or pain. Additionally, if your mother has been on anticoagulant medications due to her stroke, this could increase the risk of excessive bleeding during and after the extraction.

Given that your mother has experienced significant dental issues, including loose and misaligned teeth, it is crucial to address these problems to prevent further complications, such as infections or difficulties with nutrition. However, the decision to proceed with tooth extraction should be made cautiously and ideally in consultation with a healthcare team familiar with her medical history.

Here are some steps you can take to ensure a safe extraction process for your mother:
1. Consult a Specialist: It is advisable to seek the opinion of a dental specialist, such as an oral surgeon or a dentist with experience in treating patients with complex medical histories. They can evaluate her dental condition and overall health to determine if extraction is feasible and safe.

2. Medical Clearance: Before any dental procedure, obtaining medical clearance from her primary care physician or neurologist is essential. They can assess her current health status, review her medications, and provide recommendations regarding the timing and safety of the extraction.

3. Choose the Right Facility: Since your mother has mobility issues and may require special accommodations, consider seeking a dental clinic or hospital that specializes in treating patients with disabilities or those who have had strokes. Facilities with experience in sedation dentistry may also be beneficial, as they can provide a more comfortable experience for patients who may have difficulty sitting still or managing anxiety.

4. Discuss Anesthesia Options: Depending on her level of anxiety and discomfort, different anesthesia options can be discussed. Local anesthesia may be sufficient for simple extractions, but sedation options may be considered if she is particularly anxious or if multiple extractions are planned.

5. Post-Operative Care: After the extraction, it is crucial to have a clear plan for post-operative care. This includes managing pain, preventing infection, and ensuring she can eat and drink comfortably. Given her previous issues with swallowing, you may need to work with a speech therapist or nutritionist to ensure she receives adequate nutrition post-extraction.

6. Follow-Up Appointments: Regular follow-up appointments will be necessary to monitor her healing process and address any complications that may arise. Ensure that transportation and mobility arrangements are in place for these visits.

In summary, while your mother may be able to undergo tooth extraction, it is vital to approach this decision with careful consideration of her overall health and specific dental needs. Consulting with a multidisciplinary team, including her primary care physician and dental specialists, will help ensure that the procedure is conducted safely and effectively.

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