A tooth infection, also known as a dental abscess, is a pocket of pus that forms due to a bacterial infection, often causing pain and swelling. Facing a scheduled surgery with an active tooth infection requires careful evaluation by healthcare professionals to determine the safest path forward.
Why a Tooth Infection is a Concern
Undergoing surgery with an active tooth infection presents several medical risks. Bacteria from the infected tooth can enter the bloodstream, a condition known as bacteremia. This can happen through daily activities like brushing, but the risk increases with dental procedures or the stress of surgery. Once in the bloodstream, these bacteria can travel to other parts of the body, potentially causing new infections at the surgical site or in distant organs.
A tooth infection can increase the risk of post-operative complications, including infection at the surgical site and delayed healing. The body’s immune system is already working to fight the existing dental infection, which can weaken its ability to respond to the stress of surgery or prevent new infections. In some cases, bacteria from the mouth can contribute to serious conditions like endocarditis, an inflammation of the heart’s inner lining, especially in individuals with pre-existing heart conditions or prosthetic heart valves.
Action Steps Before Surgery
If you have a tooth infection and a planned surgery, immediate and open communication with all your healthcare providers is important. Inform your surgeon, dentist, and primary care physician about the infection as soon as possible. This allows them to collaboratively assess the situation and determine the appropriate course of action. Providing a complete medical history, including any medications you are taking, is also important for safe planning.
Many surgeons require a “dental clearance” before major procedures, especially for heart surgery, joint replacements, or organ transplants. A dental clearance involves an examination to identify and address any potential sources of oral infection, such as tooth decay, gum disease, or abscesses. Elective surgeries, which are scheduled in advance, may need to be postponed until the tooth infection is resolved to reduce the risk of complications.
Managing the Infection
Managing a tooth infection typically involves dental interventions aimed at eliminating the source of the bacteria. Antibiotics are often prescribed to control the infection and prevent its spread, particularly if the infection is severe, spreading, or if the patient has a weakened immune system. However, antibiotics alone usually do not resolve the underlying dental problem.
Primary treatments for a tooth infection often include a root canal, tooth extraction, or drainage of the abscess. Root canal therapy involves removing the infected pulp from inside the tooth, cleaning, and sealing the canals to save the tooth. If the tooth cannot be saved or the infection is extensive, extraction of the affected tooth may be necessary to remove the source of the infection. Sometimes, a dentist may drain the abscess by making a small incision to allow the pus to escape, which helps reduce swelling and pain.
When Surgery Cannot Wait
In certain emergency or life-threatening situations, delaying surgery due to a tooth infection may not be an option. For instance, in cases of severe injuries, appendicitis, or burst blood vessels, the immediate risks of postponing the surgery often outweigh the risks of proceeding with a concurrent infection.
In these critical scenarios, medical teams implement strategies to manage the infection while proceeding with the necessary surgery. This often includes aggressive antibiotic therapy to control the bacterial spread and close monitoring of the patient’s condition. Post-operative dental care is then prioritized to fully address the tooth infection once the immediate surgical crisis has passed. This approach aims to balance the urgency of the surgery with the importance of managing the existing infection.