Dental Implants and Organ Transplants: Precautions?

Are there any special precautions we should take when doing site development, bone grafts, sinus lifts or installing implants in organ transplant patients?  Most organ transplant patients will be taking immuno-suppressive drugs and will this decrease their resistance to infection?  Should we be prescribing antibiotics for all invasive procedures that involve bleeding and the potential for creating a bacteremia?  Should we have these patients on chlorhexidine rinses?  Should we have these people come at 3 month intervals for recall examinations and oral prophylaxis?  Are there any absolute or relative contra-indications for implants in these patients?  Is time since organ transplant a factor?  If let us say a patient had a kidney transplant 7 years prior, is this patient still considered at risk for complications that might leading to rejection of the transplant?

5 thoughts on “Dental Implants and Organ Transplants: Precautions?

  1. Arun Kumar JAIN says:

    Checking the patient’s current status is necessary. The time passed when the patient had, history of transplant and its success, medicaments currently being taken by the patient, patient’s general health condition etc etc. Of course the antibiotic cover and judiciouss uses of local antiseptics viz 0.2%/ 0.12% chlorhexidine, with other infection control measures will help reducing bacteremia, with better control of the procedures clinically.

  2. dr bob says:

    Please you are asking a question that tells me you do not have the training or knowledge to take on this surgical case. There are specialists who can better evalute this patient and who can better handle complications that may arrise even months after surgical placement. Unless you are prepared to take on this responsibility work the case with a team approach. You may need expert help to bail you out and if hospital admission is needed it could be problematic. You can treat a patient such as this as long as you do all you can to keep you as well as the patient out of harm. Document very carefully every step and refferal.

  3. Dr. L says:

    Dr. Bob, I think that is a very rash assumption with regard to the dentist’s skill, training and knowledge when all the dentist is asking is a simple question or perhaps for a peer based clarification. Have you referred everything you had the slightest question about? I doubt it. I think that whilst the patient may be in better hands if treated by a specialist should they be severely medically compromised but I am sure the dentist is more that aware of the patient’s med hx and is the best person to decide that as well as be aware of their ability to refer. I think it would be advantageous if everyone on this forum were perhaps more supportive that quick to judge. No disrespect intended and this post is largely directed for the benefit of everyone on the forum.

  4. dr bob says:

    Dr.L

    A rash assumption, I have to agree with you, perhaps this question was posed by a surgeon well trained in treating such cases. I should have prefaced with the operative “perhaps”.

    Yes, I do referr when I have a even a slight doubt about something that I feel has a probability of resulting in a complication that I do not have the training or knowledge to handle. If the worse case be that the patient will lose an implant, or a good deal of bone, I will take on that risk as most of us probably would. Patients have died from complications after simple sinus lifts that were done by doctors with training that knew what they were doing. This is serious stuf.

    When there is even a slight chance of a complication that could result in grave harm or death one must procede with great care. If a doctor is not prepared to deal with this potential problem on his own, then he can easily become prepared by using a team approach.

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