A Clinical Study on Safety during Tooth Extraction in Hemodialysis Patients on Antithrombotic Therapy

Abstract

Due to the current super-aging society, hemodialysis patients （HD patients） are also aging and the number of elderly HD patients visiting dentists has increased in recent years. In the oral cavity, hygiene worsens due to decreased saliva flow and decreased ADL. Systemically, cerebrovascular disorders and cardiovascular diseases are common, and many patients are treated with antithrombotic therapy. Tooth extraction in HD patients is generally avoided due to the unique nature of the disease, and patients often do not receive adequate treatment. Furthermore, there are few reports on tooth extraction in HD patients, and the safety of tooth extraction has not been sufficiently investigated. Therefore, in our department, we compared the complications that occurred during tooth extraction under continued antithrombotic therapy in an HD group and a non-HD group, and examined the safety. The results showed a statistically significant difference in gender, number of teeth extracted, bleeding complications, or other complications. Furthermore, there was a statistically significant difference in the severity of bleeding complications and gingivitis. The risk factor for serious bleeding complications during tooth extraction under continued antithrombotic therapy was local gingival inflammation, suggesting that HD may not be a risk factor. In this study, we conducted a study on normal tooth extraction in patients undergoing antithrombotic therapy, and found that there were no serious complications in either the HD or non-HD group, and there was a significant difference in complications depending on the presence or absence of HD. Therefore, it was considered that normal tooth extraction could be performed in HD patients as well as in non-HD patients.