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内容简介
许多人最怕看牙科，除非真的痛到不行，不然不愿到牙医诊所，更不用谈「拔牙」的恐惧。但日前嘉义一名女子因为蛀牙到医院就诊，牙医师发现「牙根烂了」一次拔了20颗牙，但女子在返家隔天后即昏迷，最终不幸过世。 此案件引发轩然大波，家属险质疑女子死因为拔牙后感染，因而对医院提告，但拔牙的风险真的有这么大吗？到底临床上最多一次可以拔几颗牙？ 医学界并没有限制拔牙颗数！通常同区域控制在2-4颗 医学界并没有限制拔牙颗数！通常同区域控制在2-4颗 其实对于一般健康的人，一次拔超过1颗以上的牙齿是没有问题的，艾康口腔外科医师陈昭明医师说：「当然还是尽量把拔牙颗数尽量减少，毕竟是局部麻醉，一次处理太多同一个区域打的麻醉剂量也高，对病人来讲也不太好，回去病人也会不舒服。」 因此临床上医师通常要拔，会把同一个区域控制在2-4颗，减少手术区域的大小，但事实上医学界并没有限制拔牙颗数，因为拔牙颗数还是要依据每个病人的状况来决定。 整口牙都坏了真的可能大量拔牙！细菌容易影响其他牙齿 整口牙都坏了真的可能大量拔牙！细菌容易影响其他牙齿 其实类似嘉义郑小姐的事件，曾在2003年也发生过，当时一名患有严重先天性心脏病的14岁儿童，一次拔了14颗牙后因感染过世，当时多数人都认为是拔太多颗牙造成的，家属也提告院方没有解释手术风险，该案官司后缠讼多年，最终医师跟麻醉医师被认定无过失。 所以确实有可能一次会拔超过10颗以上牙齿的情况发生，陈昭明解释：「如果口腔内同时很多颗牙齿坏掉，其实也伴随着很大量的细菌在口腔，因为细菌不可能只待在同个地方，当医师分次处理的话，如果20颗坏掉只处理了5颗，其实其他15颗还是会影响到处理过的那5颗地方。」 拔牙感染并非隔天马上出现！3-4天才会有红肿、化脓、胀痛 拔牙感染并非隔天马上出现！3-4天才会有红肿、化脓、胀痛 当然也必须要考量到患者本身的身体状况怎么样，如果是免疫力较差的人，就相对有可能造成手术后的感染，但这种手术的感染不会是在隔天马上显现。 陈昭明提到：「拔牙后的感染，或是其他手术的感染，任何有伤口的感染不会是在手术或是拔牙后的隔天出。因为人体抵抗细菌的过程，一定需要累积到一定的时间，细菌够高很大的机率才会产生化脓，一定是慢慢累积3-4天后之后，才会出现红肿、化脓、胀痛等感染的状况。」 三大要素影响拔牙感染机率 三大要素影响拔牙感染机率 拔牙后会感染主要可从三要素来看： 细菌够多 本身免疫好不好 感染的源头有没有移除 任何三个只有一项存在就会增加感染的机会，基本上，要先了解是什么原因去拔牙，陈昭明举例，如果已经在肿就代表细菌量很高，这个时间点拔有会两种可能。 一、就是把感染源去掉，免疫力很快就压制就好了。二、本身免疫力不好，细菌还是会不断繁殖，或是患者不照时间吃药，没有控制好口腔卫生、本身有糖慢性病，这样增加感染的机会就比较高。 一般健康人拔牙不会有问题！注意伤口的清洁维护 一般健康人拔牙不会有问题！注意伤口的清洁维护 陈昭明强调：「一般人是很少出现感染的情况，包含只是一般牙齿被蛀掉，或是牙周病很严重牙齿在摇，只要本身没有感染情况，身体状况也良好，基本上拔牙是不会有任何问题。」民众不需要过于担心。 只是拔牙后的照顾也格外重要，医师通常比较担心民众虽然有听医师讲，但没有好好做到，比如说不要喝酒、不要吃槟榔，或是再清洁时怕痛没有好好清，是有很多原因可能造成发炎。 拔牙虽然是口腔外科常见手术，但别以为拔牙是小事就忽略，拔完后尽量吃温或凉的软质食物，避免太硬、太热及刺激性食物，可多喝果汁补充维他命 C，增进伤口愈合。 举报/反馈
