1.Patients with cardiovascular disease
Those with severe cardiovascular disease and high blood pressure above 180/100 mmHg. Patients with heart disease in general can have their teeth extracted as long as they do not show signs of cardiac insufficiency (such as shortness of breath with mild activity or lying down). However, when extracting teeth, it should be done as follows: do not add epinephrine to the anesthetic to avoid tachycardia and induce heart failure; complete anesthesia and gentle movements to minimize adverse stimulation, bleeding or injury; anti-infection prophylaxis should be given before and after tooth extraction because the resistance of heart disease patients is reduced and they are more prone to co-infection than normal people.
2. Patients with high blood pressure
Hemorrhagic diseases: Patients with hemophilia and primary thrombocytopenic purpura, for example, have disorders in the coagulation process in their bodies, so they have a tendency to bleed. The bleeding is difficult to stop after extraction, which can cause hemorrhage and life-threatening. As for patients with leukemia, since they are highly susceptible to infection, the incision after tooth extraction can also become a focus of infection, which can lead to serious systemic infection and is difficult to control. Therefore, when these patients suffer from dental disease, they should be treated conservatively and tooth extraction is contraindicated.
3.Menstrual period
In principle, women should avoid tooth extraction during menstruation, because compensatory bleeding may occur in the tooth socket during menstruation. However, the extraction of loose teeth during menstruation has little effect on the patient. Some “deep-rooted” teeth, such as obstructed teeth or buried teeth, should be extracted after menstruation. According to some data, it is most appropriate for women to have their teeth extracted around the 10th day of their menstrual cycle, when the wound heals faster and bacterial infection is less likely to occur.
4. During pregnancy
Some people think that no tooth extraction is allowed during pregnancy because it may lead to miscarriage. However, a lot of clinical practice shows that tooth extraction during the 3rd to 7th month of pregnancy is safer and has no adverse effect on pregnancy. The following points should also be noted when extracting teeth during this period.
① Intramuscular injection of progesterone 10 mg on the day before and on the day of tooth extraction.
(ii) Epinephrine must not be added to the anesthetic for tooth extraction.
③Anesthesia must be complete and the pain relief effect should be good. For patients with a history of habitual miscarriage or habitual preterm birth, tooth extraction is prohibited during pregnancy.
5.Lactation period
Tooth extraction is completely possible during breastfeeding. Some people say that tooth extraction during this period will interrupt or reduce milk secretion. This statement is not scientific. Clinical practice shows that there is no effect on lactation. However, do not take antibacterial drugs; the drugs and their metabolites can pass through the breast milk possibly affecting the baby. During taking contraceptive pills, the pill can increase the decomposition of fibrin in the body, so that the wound can not form a good blood clot, germs can easily take advantage of the situation to cause infection and affect wound healing.
6, liver, kidney function disease patients
Patients with chronic hepatitis and cirrhosis, for example, have a tendency to bleed due to poor liver function, which reduces the content of prothrombin and fibrinogen involved in the coagulation process, and the wound will bleed more than once after tooth extraction. Therefore, appropriate amount of vitamin K should be supplemented before tooth extraction for such patients to promote prothrombinogen synthesis to supplement the deficiency of fibrinogen in order to avoid accidents.
(5) Tooth extraction should be avoided in malignant tumors and during the onset of psychosis.
(6) Before the symptoms of diabetes mellitus are controlled.
(7) Tooth extraction should not be done after strenuous exercise, labor or alcohol consumption.
(8) Those with a history of allergy to procaine anesthetics (some can be replaced by acupressure or needle anesthesia).
(9) Patients with inflammatory period of cold should also be cautious in tooth extraction.
7. Hyperthyroidism
Such patients may suffer from thyroid crisis due to infection, surgery, anxiety, and in severe cases may cause failure or even death, so it is not advisable to take the risk of tooth extraction. If tooth extraction is necessary, a detailed examination should be done so that their basal metabolism is below +20%, pulse is below 100 beats per minute, no epinephrine vasoconstrictor is added to the anesthetic, and antibiotics should be taken before and after the surgery.
8.Acute infectious disease
Pernicious anemia, severe tuberculosis, malnutrition, and overexertion can reduce the body’s resistance, delay wound healing, and combine with infection, therefore, tooth extraction should be suspended.
9. Patients with organic and functional neurological disorders
If tooth extraction is necessary, surgery should be performed only after consultation and treatment by a neurologist, and sedation should be given before surgery.
10. Ulcerative lesions of the oral mucosa
Such as acute gingivitis, stomatitis, etc. should be suspended for tooth extraction.
11. Teeth located in the area of malignant tumor
It is forbidden to extract the tooth alone, but the whole tooth should be removed together with the tumor at the same time. Therefore, if there is a long-lasting ulcer or swelling in the affected tooth area, a biopsy should be taken first to exclude malignant tumor before extraction.
12. Teeth in the radiation treatment area
Teeth should not be extracted during and within one year after the completion of radiation therapy to avoid radioactive pulpitis. If tooth extraction is necessary after one year of radiotherapy, antibiotics should be used to prevent postoperative infection.