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Pre-operative risk: Underestimating Dental Care

One tragedy of our first world nation is that many patients suffer from very poor dental care. Whilst we doctors are in the midst of mobilising many older patients with joint replacements and cardiac stenting, there is a real danger that pre-operative dental care is forgotten.

James was a jovial, relatively toothless man in his 60s who saw me for pain management before his bilateral knee replacements. He had not seen a dentist for many years but had no medical problems except arthritis. His toothless smile saved him… he took my strong advice and saw a dentist the week before the operation. As a result, he had two of his remaining five teeth removed, his mouth was well cleaned and the operation delayed due to the infection risk.

This case proves it is not enough to rely on the surgeon and anaesthetist to optimise our patients’ pre-operative health. This is our job as GPs and we must always remember what lies behind the patient’s smile…