Journal of Disability and Oral Health
- Cover Date:
- December 2017
- Print ISSN:
- 1470-8558
- Vol:
- 18
- Issue:
- 4
The gastric pacemaker and its implications for dental treatment
Background: Gastroparesis is a chronic condition characterised by a delay in gastric emptying and can be
profoundly disabling with symptoms including nausea, vomiting and abdominal bloating. In those cases refractory
to medical intervention, a high-frequency gastric electrical stimulation device (gastric pacemaker) can offer an
improved quality of life. Manufacturers of the device recommend that it is deactivated during any dental treatment
involving use of a dental drill, the aim being to prevent electromagnetic stimulation that may damage the
neurostimulator or interfere with its operation. This case report describes the patient and practitioner journey in
coordinating dental care for the patient with a gastric pacemaker. Case summary: This case study describes the management of the delivery of dental treatment for a 47 year old female patient with an Enterra® gastric pacemaker. Her gastroparesis was associated with a diagnosis of systemic sclerosis. Her presenting complaint was a fractured upper left second molar. On examination, further dental caries was noted in the upper left first molar and lower right third molar. Prior to embarking on treatment, a multidisciplinary team was consulted including a consultant in Upper Gastrointestinal Surgery and the Medtronic manufacturing team. Despite differing views on management of the device, in accordance with the manufacturing guidance it was deactivated during dental treatment. An extraction and two restorations were performed with no notable deleterious effect to the patient. The reactivation process was uneventful and the patient was satisfied with the outcome. Conclusions: The patient with a gastric pacemaker can be managed safely in the dental setting with input from the gastroenterology team and the manufacturing team. De- and re-activation is relatively simple and ensures that the risk to both device and patient is reduced as far as is reasonably practicable.
Key words: Special care dentistry, gastric pacemaker
- Article Price
- £15.00
- Institution Article Price
- £
- Page Start
- 132
- Page End
- 137
- Authors
- Janine Doughty, Hana Cho, Navdeep Kumar
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