How to Handle Medically Compromised Patients
Hi, I’m Dr. Todd Shatkin and welcome to this Monday Morning Minute. Today I want to talk to you about how to handle medically compromised patients. You may be concerned about doing many implants or any kind of implants on patients who are on steroids, who have diabetes, who are on a whole host of medications, or maybe they’re on blood thinners, things like that. It’s very important to know your patients to understand what’s going on with that patient. Are they on different medications? What do the medications do for them, and how could that affect the outcome of your procedure? And one of the things that’s great about the mini dental implants is it’s a very minimally invasive procedure.
You see, the term mini, although we always think of it as the size, in my mind, and what I try to portray to our patients is mini doesn’t just mean size. It means it’s minimally invasive. There’s minimal time involved to have the procedure done, minimal office visits, minimal pain, and minimal cost. So many can connotate a number of different things in the context of the surgical procedure. It’s a minimally invasive procedure. And because of that, people who take certain medications can still have this procedure done.
You see steroids, for example, they interfere with the autoimmune system. They make you immune suppressed, and that’s how they work. But at the same time, they cause people to heal at a slower rate. But the great thing about mini implants is you’re not relying on the body’s ability to heal very much. With a conventional implant, you have to make a flap. You make osteotomies in the bone, you traumatize the bone, and then you rely on the body’s ability to heal. With the mini implants, we don’t do any of that. So mini implants heal much more rapidly.
So patients who are on steroids, patients who take certain medications, patients that are diabetic, they can all have the mini implant procedure performed very efficiently and very safely, and they will still heal very normally. So you don’t really have to worry about your patients who are on steroids for mini implants. Now, let’s talk about blood thinners, for example. There’s an awful lot of different blood thinners out there, and you need to learn which ones are out there because they change all the time. But for example, let’s talk about warfarin or somebody who’s on cumidin.
That’s a warfarin product. Or Plavix, for example, or even just baby aspirin. Those are all types of blood thinners. And you’ll ask your patient, are you taking a blood thinner? They’ll say no. And you’ll later find out that they take baby aspirin every day. Well, they are on blood thinners because baby aspirin is a blood thinner, and it will cause an increase in bleeding. Now, if you’re extracting teeth or you’re making a flap or you’re doing invasive surgery, you’ve got to talk to the patient’s physician about the possibility of reducing the amount of blood thinners or cutting it out for four or five days prior to surgery and a couple of days after.
But if you’re doing just straightforward mini implants without any surgery, you’re making a little tiny pilot hole in the gum. You thread the implants in for, like, a denture stabilization. You don’t need to worry about the blood thinners. You can do the procedure as soon as that implant goes in the bone, it will stop any bleeding. So, yeah, when you make your pilot hole, you might get a little bleeding. As soon as you plug it up with the implant, the bleeding stops.
So don’t be concerned about blood thinners with nonsurgical mini implant procedures. If you’re doing surgery, you need to be cautious and talk to the doctor and see if and when you can stop those blood thinners. So the bottom line is mini implants are much less invasive, much less of a procedure than conventional implants. And in 95% of the time, the patient can continue to take the medications they’re on.
There’s very little risk of any problem with patients who have diabetes or taking steroids or blood thinners with many implants unless you’re doing a more invasive procedure. I hope this helps you understand the medical compromise patient. And we’re always here to answer your questions if you have a specific patient that you want to talk about. It’s good to be here, and I’ll see you on the next Monday Morning Minute.