Why dentistry in a multidisciplinary clinic is safer

Re-implantation or work with bone tissue is serious surgery. As in general surgery, it requires strict protocols: pre-operative preparation, surgical checklists, haemostasis control and risk management. Under Russian clinical guidelines, the organisation must ensure safety at every stage — from the anaesthesiologist's assessment to post-operative care.

Anaesthesia is the basis of comfortable treatment and a high-risk zone. According to FDA data, 46.2 percent of adverse reactions to local anaesthetics in dentistry are serious: requiring hospitalisation or life-threatening. The risk is especially high with vasoconstrictor-containing anaesthetics and ester anaesthetics. Anaphylactic and anaphylactoid reactions are rare but develop rapidly — only timely adrenaline and a resuscitation kit in the room can save a life. A clinic must have emergency-management protocols.

Dentistry is a high-risk zone for parenteral transmission through blood and saliva. The turbine drill and ultrasonic scalers create a bioaerosol cloud carrying particles of the patient's blood and saliva. According to WHO and CDC, strict instrument sterilisation, antiseptic surface treatment and personal protective equipment are the only barrier against transmission of hepatitis B, C and HIV.

Dentistry is part of overall health. Chronic conditions directly affect treatment outcomes and may contraindicate aggressive interventions such as implantation.

1. •

   Cardiovascular disease

   Patients on antiplatelets and anticoagulants need a special approach because of bleeding and thrombosis risk.

2. •

   Endocrine disease

   Diabetes increases the risk of peri-implantitis and implant rejection.

3. •

   Osteopenia and bisphosphonates

   A direct contraindication to implantation without careful preparation, due to the risk of jaw osteonecrosis.

A multidisciplinary clinic differs from an ordinary office in that, before complex intervention, a patient is assessed not only by the dental surgeon but also by a physician and, if needed, by specialists. Only then is full patient routing and safe treatment possible.

Safety is not the absence of error but the ability of a system to adapt and run without failures in any conditions, to apply risk management and to train its people. When choosing a clinic, make sure it works on the principles of a multidisciplinary medical institution.