Dental Clearance: Why It’s Important To Take Before Major Surgery

What is dental clearance?

Dental clearance is an examination that aims to assess your oral health and address dental problems before undergoing major surgery or cancer treatment procedures. If dental health issues are not properly treated before such procedures, there's a risk that oral bacteria enter the bloodstream and cause infections at the surgery site. Dental clearance aims to reduce the risk of complications and improve the surgical result.

Why do you need dental clearance before surgery?

Poor oral health before a major surgery can increase the risk of infection and complications at the surgical site, both during and after the procedure. To minimise these risks, dental clearance is essential to identify and address potential sources of oral infection. Here are possible complications that might happen if dental clearance is overlooked, including:

• Cardiovascular disease

  • When you undergo heart surgery, bacteria from the teeth can enter the bloodstream, potentially leading to a condition known as bacteremia. 

  • Such bacteria may contribute to the formation of blood clots in vessels, causing inflammation that can block arteries and increase the risk of heart attack or stroke.

• Endocarditis

  • This condition is the inflammation of the inner lining (endocardium) of the heart chambers and valves. 

  • Endocarditis happens when bacteria from another part of the body, such as the mouth, spread through the bloodstream and attach to damaged areas in the heart.

  • Infection of the endocardium is rare but can be fatal if not treated early.

• Joint issues 

  • Bacteria from the mouth entering the bloodstream is one of the factors that can cause and worsen the development of rheumatoid arthritis.

When is dental clearance necessary?

Dental clearance is usually performed prior to any major surgeries, as untreated dental issues could potentially lead to complications. The following types of operations usually require dental procedures beforehand:

• Major surgeries

  • Before undergoing major procedures such as total hip replacement or heart surgery, dental procedures are necessary to check for any oral infections, cavities, or gum disease that could cause complications during or after surgery.

• Organ transplant

  • Patients undergoing organ transplants, such as the kidney, liver, or heart, require dental clearance to decrease the risk of infection.

  • Any untreated dental issues can increase the risk of infection after transplant surgery due to the immunosuppressive drugs used to prevent organ rejection.

• Joint replacement surgery 

  • For patients undergoing procedures like hip or knee replacement, dental clearance may be needed to prevent infection risks. This is because the bacteria from oral infections can travel to joints, causing complications.

• General anaesthesia

  • Dental clearance is also performed to ensure there's no risk of tooth dislodging when a breathing tube is inserted during general anaesthesia.

  • Additionally, the production of saliva that helps to protect the mouth also decreases during anaesthesia, which increases the chance of infection by bacteria. 

• Cancer treatment

  • Patients undergoing chemotherapy or radiation therapy, especially to the head and neck, may need dental clearance to assess their oral health condition.

  • Because these treatments can impact the salivary glands, which reduces saliva production that helps protect the mouth, increasing the risk of oral infection.

Dental clearance consultation

Before surgery, your surgeon will determine whether you need to see a dentist for a pre-surgical dental evaluation. If you were instructed to go for a dental examination, the dentist will examine your mouth, gums, and teeth thoroughly.

This assessment aims to identify any signs of tooth decay, gum disease, infections, or other dental issues that could affect your overall health or cause complications during the upcoming major procedure.

Following the examination, the dentist may perform X-rays to assess the condition of your teeth and the underlying bone structure. This imaging test is used to detect cavities or abscesses that may not be visible during a regular examination.

Dental treatment options

If there are any problems with your teeth, gums, or mouth during the examination, the dentist may perform a variety of treatments, such as:

• Dental fillings to repair cavities.

• Root canal treatment for infected tooth pulp.

• Tooth extractions if the teeth are severely damaged.

• Scaling to remove plaque and tartar (hardened plaque).

• Root planing to smooth out the teeth roots to help gums reattach to the teeth.

• Antibiotics, if there are signs of infection.

Always follow your dentist’s recommendations and maintain regular checkups to maintain your oral hygiene for any medical treatment or procedure.

At Thomson Dental Centre, our dentists will take care of your oral hygiene pre-surgery. We understand the significance of oral health to your overall well-being and are devoted to providing personalised dental services tailored to your needs.

Cost of dental clearance in Singapore

The cost of dental clearance in Singapore can vary based on the type of dental services, condition of the teeth, and whether the procedures are conducted at a public or private clinic. In general, here are the costs of this procedure in Singapore:

• Dental consultation

  • The dental clearance begins with a consultation and examination, which can cost between SGD 9 in subsidised polyclinics and SGD 20 to SGD 54 in private clinics.

• Diagnostic services 

• To assess your oral health, the dentist may recommend dental X-rays imaging which can cost between SGD 20 and SGD 300, depending on where the tests are done.

  • Public institutions like polyclinics may charge less, but private clinics often have shorter waiting times.

Other than the initial assessments above, there are other procedures that may be performed as part of your assessments, including:

• Dental fillings to repair cavities, which can cost between SGD 76 and 327 per tooth.

• Scaling that can range from SGD 45 to 160.

• Tooth extractions if the teeth are severely damaged from SGD 28 to 250 per tooth.

• Root canal treatment for infected tooth pulp, which ranges from SGD 436 to 1300.

The total cost for dental clearance procedures can vary depending on the services, if there's any additional treatments, or whether it is subsidised or not. These treatments and costs will be discussed with you during consultation.

Available payment options

• Community Health Assist Scheme (CHAS) orange and blue

• Merdeka Generation (MG)

• Pioneer Generation (PG)

• Other health insurances

Factors affecting the cost

• Actual costs may vary based on individual medical conditions and type of facility (public or private).

• Additional charges may apply for more complex procedures (more than 1 tooth).

• Treatment plans are customised to the condition of each patient.

• Fees are subject to change.

The information provided above is intended for general reference only. For detailed fee information and payment options, please consult with your dental care provider and insurers directly. Request an appointment with our specialists at Thomson Medical today for a detailed breakdown and personalised care plan.

FAQ

What does dental clearance mean?

Dental clearance is an examination of your oral health before major surgery or medical treatment. During this process, a dentist thoroughly examines your teeth, gums, and mouth to identify and treat any dental issues that could potentially cause complications during or after your medical procedure.

What is a total dental clearance?

A total dental clearance is the procedure of removing and replacing all of a person’s teeth because of severe gum conditions. Before the procedure, the dentist will perform examinations and may perform X-rays imaging to assess your oral health.

Why do you need dental clearance before radiation?

Dental clearance before radiation therapy, especially to the head and neck area, is important. Because this treatment affects the salivary glands, which decreases the volume of saliva produced. This significantly increases your risk of oral infections and conditions after the radiation treatments.

What do you write in a dental clearance?

Simply put, receiving dental clearance means that your dentist has approved your upcoming dental procedure. To make this decision, a dentist will usually do a detailed oral examination, which includes checking your dental history and other additional tests.

Can you have surgery with bad teeth?

No, you can't. As it increases infection risk, your surgeon will advise you to delay your surgery to fix any oral health issue. Adhering to this plan is advisable to prevent possible risks that bad teeth pose to surgical sites.

The information provided is intended for general guidance only and should not be considered medical advice. For personalised recommendations and tailored advice, you can consult a dentist at Thomson Dental Centre.