Liver disease and tooth extraction.

The human body is one unit so you have to help your dentist to record carefully a full medical history for you. Liver problems are of the medical conditions that needs special care in dental clinic. liver diseases has many types but the most common are liver fibrosis as a result of viral infection or parasitic infection (belharizeases in some countries).

Dentist usually give extra care to liver patients because Liver is responsible of producing most of the factors that are essential for blood clotting. So viral hepatitis or any other distructive liver diseases can impair the normal coagulation mechanism and the patient of the uncontrolled liver disease tend to bleed more after surgery or tooth extraction. There is also an crossinfection risk if viral hepatitis(The most common liver problem) is present.

bleeding tendency: The diagnosis should be confirmed by a physician and the severity of liver affection should be taken into consideration by arranging for a coagulation screen tests  before any surgical treatment like extraction. Patients may need vitamin K or freshfrozen plasma to gain enough coagulation and, therefore, should be managed in hospital and the dentist also will concentrate on local methods of reducing post extraction bleeding like stitching or mesh supported dressing.

Drugs & medications: Drugs prescription is really dilemma as liver is responsible for the breakage and excretion of many toxic chemical materials including many drugs. Also there is some drugs that considered liver toxic and can really hurt the liver in compromised patients. so many drugs should be used with caution or avoided completely in severe liver disease. Paracetamol, NSAIDs, sedatives that usually prescribed after extraction or surgery  are the most common. Any drug prescribing should include reference to a drug formulary.  As some drugs even with normal dose can be txic to liver patient because he fails to break and excrete the drug so it accumulate in the body.  It is difficult to estimate the impairment of drug metabolism even with liver function tests so adjusting the doses of drugs can be very hard even for the experienced physician .

Cross viral infection:The most common form of liver disease is the A,B and C viral hepatitis caused by HAV, HBV AND HCV  so the routine precautions for infection control is essential which  means that all patients who needs extraction or any other oral surgery treatment, whether known high risk or not, should be managed in the same strict way to eliminate the risk of transmission of infectious agents like viruses and bacteria.