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Dental treatment in patients with liver disease.
mr_wilsonwilson posted:
Hello, 61 year old male here

I must have dental/oral surgery (all upper teeth extracted). I was diagnosed with Cirrhosis in 2003 from alcohol. Of course I quit all alcohol immediately on the diagnosis. My liver panel blood work (every 6 months since) has been in the normal range - No esophageal varices etc.. (if it wasn't for a couple small nodes-nodules? on my liver one would wonder why I was diagnosed with cirrhosis) No Hep C or hepatitis of any kind, Spleen normal, pancreas normal.

Medicine I take:
50 mg@day Cozaar
60 mg@day generic adderall
1000 mg@day fish oil
400mg@day folic acid
low dose aspirin
Walmart equivalent Prilosec 20mg@day

Having said all that, my question is:

What dental drugs should I avoid before, during tand after this surgery?

I've read this publication:
J Clin Exp Dent. 2011;3(2):e127-34. Dental treatment in patients with liver disease.
Journal section: Oral Medicine and Pathology doi:10.4317/jced.3.e127 Publication Types: Review
Dental considerations in patients with liver disease
Marta Cruz-Pamplona 1, Maria Margaix-Munoz 1, Maria Gracia Sarrion-Perez 1
1 Degree in Dentistry. Master in Oral Medicine and Surgery. Faculty of Medicine and Dentistry. University of Valencia. Spain.

And from what I've read my situation is not as dire as those studied

Thank you
Zev Kaufman, DDS responded:
Dear Mr. Wilson:

Yours is a perfect example proper information is good and little information is dangerous.

Many drugs are metabolized by the liver. However, your problems with your teeth are far worse, since they all have to be removed.
Since I do not know why your teeth need to be extracted, and whether the work will be done under sedation, or if you will need to use some analgesics afterwords, the discussion is moot.

If you are going to an oral surgeon, or a general dentist to have the work done, he/she will be able to tell you exactly what drugs will be reuired for the procedure and which ones to avoid.

I am sorry for the evasive answer, but it is impossible for me to review the pharmacology of all dental drugs that might be used on you. I don't even know which local anesthetic your dentist will use (novocaine hasn't been used in years, and there are several different anesthetics available to your dentist to choose from).

Please ask your dentist for guidance. It is part of the work to be done on you.

Best of luck,
Dr. Zev Kaufman
mr_wilsonwilson replied to Zev Kaufman, DDS's response:
Thank you Doctor.
When I revisited my question I realized it was like a disconnected saying I use to say in elementary school, "Do you walk to school or carry your lunch." there is no logical way to answer without much more information.

I think it will be "Conscience Sedation". They are NOT broken off at the gum line because of my liver injury - A lot of heredity and may be the fact I became a lac to-ovo.vegetarian after since I received my diagnosis. I do know from my Psychiatrist with an anesthesiologist degree as well Vicaprofin(sp) would be the best pain med if needed. More later
Again thank you
Zev Kaufman, DDS replied to mr_wilsonwilson's response:
Dear Mr. Wilson:

I am glad that I helped you get thing clearer.

Best of luck to your doctors and to you.

Have a speedy recovery,
Dr. Zev Kaufman

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