Tooth extraction - indications, contraindications and important information

Systemic contraindications

Some medical conditions may make it difficult or completely impossible to perform the procedure safely. In such cases, the extraction should be consulted with a specialist or rescheduled.

• Cardiovascular diseases - certain heart conditions may be a contraindication to the procedure
• Blood coagulation disorders - if the patient is taking anticoagulants (e.g. warfarin), it is necessary to consult with the treating physician for possible modification of the treatment before the procedure.
• Pregnancy - in the first trimester and at the end of the third trimester, the procedure is only possible in emergencies, such as acute inflammation.
• Systemic diseases in exacerbation - unbalanced diabetes, active viral (flu, COVID-19) or bacterial infections (e.g. angina), exacerbation of chronic diseases (e.g. asthma, rheumatoid arthritis).
• Cancer and oncological diseases - Patients undergoing chemotherapy or radiotherapy require a consultation with an oncologist before an extraction is performed.

Local contraindications

In certain situations, local oral conditions may contraindicate the immediate removal of a tooth.

• Tooth/teeth in the tumour field - requires a special approach
• Active inflammation at the treatment site - The presence of an abscess, pus or serious infection may require prior antibiotic treatment before deciding on extraction.
• Presence of a tumour or cyst in the tooth area - requires careful diagnosis and appropriate preparation before surgery.
• Excessive tooth mobility - e.g. in advanced periodontitis, the procedure requires special care, especially if additional risk factors are present.

Temporary contraindications (requiring postponement of the procedure)

Some situations may require postponing the procedure to a more appropriate time to ensure maximum safety for the patient.

• Patient malaise - Fever, weakness, upper respiratory tract infection, menstruation.
• Unregulated medical conditions - uncompensated hypertension, diabetes or other chronic diseases.
• Taking medication that affects healing - use of steroids, bisphosphonates can increase the risk of complications such as bone necrosis.

For the procedure to proceed safely and comfortably, the patient should:

• Take prescribed medication - unless otherwise advised by the dentist or practitioner.
• Inform your doctor of any medication you are taking - especially those affecting blood clotting.
• Report any allergies and chronic diseases - This is crucial for the safety of the procedure.

Some symptoms may indicate complications and require urgent consultation:

• Heavy, prolonged bleeding
• Pain that does not subside after 2-3 days or gets worse
• Fever and chills
• Unpleasant odour and taste in the mouth - which may be indicative of alveolitis