Dialysis Dental Timing — MFDS Part 1 MCQ

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ModerateHuman DiseaseDialysis Dental TimingMFDS Part 1

A patient with end-stage kidney disease receives intermittent haemodialysis using anticoagulation of the dialysis circuit. The patient requires an elective dental extraction. When should the procedure generally be scheduled?

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Correct answer: C — On the day after a haemodialysis session

The best answer is C. Elective invasive dental treatment is generally scheduled on the day after haemodialysis, when fluid and metabolic status have been optimised and the anticoagulant administered for the dialysis circuit is less likely to contribute to procedural bleeding. Treatment during dialysis is impractical and unsafe. An extraction immediately before dialysis is undesirable because subsequent dialysis anticoagulation could interfere with haemostasis. Timing is not irrelevant, but haemodialysis is not itself a contraindication to dental treatment. The dentist should also liaise with the renal team, review relevant blood results and medicines, and avoid blood-pressure cuffs or venepuncture in an arm containing an arteriovenous fistula.

Reference: AlMuzaini AA. Patient on Hemodialysis with Elevated International Normalized Ratio Presents for Removal of Residual Roots in the Mandible. Dental Clinics of North America. 2023;67(3):543-545. https://pubmed.ncbi.nlm.nih.gov/37244736/