I am having my widsom teeth extracted on Friday and I have Rheumatoid Arthritis. I am being “put under” with general anesthetics. Are there any extra risks involved with being put under because of the Rheumatoid Arthritis? I will be stopping my meds before and after the surgery, but just wondering if that alone will keep me safe.
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Rheumatoid Arthritis DOES carry a significant number of increased risks, which I am sure your anesthesiologist is well aware of – this is a BIGGEE in anesthesia training. Of note – people with rheumatoid can have pulmonary and cardiac issues, beyond mere joint issues. Of special import – should an emergency arise and you would have to be intubated, people with rheumatoid can have unstable atlanto-occiptal joints in the neck which they are unaware of (it can only be found on a special X-Ray taken to find this problem before surgery); intubation on such people can cause severe subluxation leading to complete paralysis (and can be VERY difficult for a number of other reasons). Finally, common rheumatoid medicines can be demanding on the liver for metabolism – so be sure to tell your anesthesiologist ALL the medicines you are taking.
If you are having your wisdom teeth out, you will probably not have an anesthesiologist. Dentists administer their own GA, and do NOT follow the same standards of safety that we anesthesiologists do.
You should NOT stop your meds. In fact, if you are on steroids, you will need a stress dose of them (usually given IV) before and after the procedure.
There is an increased chance of spinal problems in the neck, if the dentist moves your head too much during the procedure. There is also a chance that even with additional steroids, your RA will get worse for awhile.
You need to see your rheumatologist and have him/her contact the dentist and give specific instructions regarding your care.
Personally, I’d get an anesthesiologist involved, but I’m sort of a safety nut.