Oral Surgery on the Patient with Cirrhosis

Chapter

Abstract

The patient with cirrhosis should undergo a comprehensive dental evaluation and treatment of all active disease to reduce the risk for dental infection. This is based on the compromised immune status of these patients secondary to end-stage liver disease and when liver transplantation is being considered. As of 2012, 61% of the adults on the liver transplant wait list had primary liver diseases attributable to hepatitis C, alcoholic cirrhosis, or subsequent hepatocellular carcinoma. It is, therefore, likely that many of these patients’ lifestyles were not conducive to having had regular dental care or maintaining good oral health. Additionally, socioeconomic limitations, older age, further deterioration of dental health during the progression of their liver disease, and time constraints may indicate a need for dental extractions. Treatment concerns associated with dental surgery for patients with cirrhosis include risk of infection, coagulopathies, and appropriate use of analgesics and anesthetics, all of which will be addressed in this chapter.

Keywords

Analgesia Bacterial infections Cirrhosis Dental care Dental health Hemostatic techniques Immunocompromised host Perioperative procedures Substance abuse 

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Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  1. 1.Department of Diagnostic SciencesUniversity of Pittsburgh School of Dental MedicinePittsburghUSA

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