Risk factors and management of adverse events in tooth extraction among medically compromised patients

Tooth extraction in medically compromised adults presents significant clinical challenges due to an increased risk of bleeding, infection, delayed healing, and systemic complications. The review indicated that Diabetes mellitus affects 8-12% of dental patients and is associated with a 10-15% risk of intraoperative hypoglycemia, while anticoagulated patients experience postoperative bleeding in 8-12% of cases compared with 2-3% in controls. Hypertension affects up to 30% of adults, leading to perioperative blood pressure elevations in 20-25%, and asthma or chronic obstructive pulmonary disease COPD occurs in 7-10% of patients with a 3-6% risk of bronchospasm. Immunosuppressed and transplant patients show postoperative infection rates as high as 20%. Five structured tables summarize medical classifications, safe clinical thresholds, emergency management, referral criteria, and a stepwise safety ladder for pre-, intra-, and postoperative care. The review emphasizes the importance of strict risk stratification and adherence to validated clinical cut-offs, including HbA1c <9%, INR ≤3.5, and blood pressure <180/110 mmHg. Implementation of standardized safety ladders and evidence-based thresholds can enhance patient safety, improve decision-making, and promote global consistency in managing medically compromised dental patients.