Long-term corticosteroid administration induces secondary adrenal insufficiency and an increased susceptibility to infection. Surgical intervention in patients receiving steroid medication should be performed with consideration to preventing adrenal crisis, delayed wound healing, and infection. To securely manage tooth extraction in patients receiving steroid medication, 50 patients taking predonisolone (PSL) were retrospectively investigated. The mean dosage of PSL in the patients was 14.2mg/day, and the mean duration of the treatment was 7 years and 3 months. Forty-nine of the 50 patients were treated under local anesthesia, and the number of teeth concurrently removed was from 1 to 4. Preoperative supplemental steroid administration was applied to only two patients: one treated under general anesthesia, and the other during a period of reducing steroid dosage. Penicillin was commonly selected as the antibiotic to prevent infection, and it was administered preoperatively and postoperatively, for a mean duration of 4.1 days. As complications, infection occurred in 2 cases, and dry socket and discomfort in 1 case for each, in whom PSL had been taken for more than 12 years. These results suggested that removal of teeth in patients taking steroid medication can be securely performed without supplemental steroid by using effective administration of antibiotics.
