Question

Why dental extraction contraindicated in adrenal insufficiency?

Answer 1

Cortisol, a glucocorticoid produced by adrenal cortex is essential for the human body to survive in stressful situations. The deficiency of cortisol in the human body leads to adrenal insufficiency which in turn can compromise the individual’s ability to adapt to a stressful situation, such as a dental appointment.

Adrenal insufficiency can manifest as loss of consciousness, a decrease in peripheral vascular resistance, shock, and ventricular asystole leading to death.

Based on the underlying pathophysiology, adrenal insufficiency can be classified as primary adrenal insufficiency(Addison’s disease) due to autoimmune adrenalitis, and secondary adrenal insufficiency due to disuse atrophy of the adrenal cortex induced by the exogenous use of the gluococorticosteroids. At present, secondary adrenal insufficiency is more common and the incidences of acute adrenal crisis are much higher among people with secondary adrenal insufficiency.

Answer 2

Answer:

The major predisposing factor of acute adrenal insufficiency is the inability of adrenal cortex to produce additional cortisol in stressful situations. ... In a dental office, the primary precipitating factor of acute adrenal insufficiency is stress.