Low Leukocyte Count, Antimicrobial and Tooth Extraction

Why A Person Whose Blood Test Shows An Abnormally Low Leukocyte Count Should Be Given An Antimicrobial Drug Before A Tooth Extraction.

The main objective of white blood cells (WBC) is to protect the body continuously by fighting infections. Blood tests are sometimes conducted to assess an individual’s complete blood count (CBC) and to determine whether their body is capable of fighting infection. An abnormally low leukocyte count is, therefore, a cause for concern since it may be an indication of an underlying medical problem which may expose patients to the risk of infection.  According to Skalak et al., (2016), low leucocyte count refers to a WBC count below 4,000 and an indication that the body might be unable to fight off infection in case of an attack. Surgical procedures often expose individuals with a low WBC count to increased risk of an adverse healthcare outcome due to the inability of the leucocytes to fight invaders in the system.

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A low leucocyte count can be attributed to several causes but is extricable linked to bone marrow problems. The bone marrow is tasked with the continuous production of WBCs to maintain optimum levels of in the blood. However, damage to the bone marrow due to exposure to certain chemicals or radiation may hinder its ability to produce a sufficient amount of WBC required to fight infections. WBCs may be also be destroyed by autoimmune disease  such as lupus, which drastically reduces the levels of leucocytes required to maintain a healthy immune system. Severe viral infections may also disrupt the marrow’s normal functioning, ultimately diminishing its capabilities.

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            Typically, a person whose blood test indicates an abnormally low leukocyte count should be given an antimicrobial drug before minor surgical procedures such as tooth extraction. This is mainly due to the fact that tooth extraction is an invasive dental procedure known for increasing the likelihood of infection with transient bacteremia such as Streptococcus Viridans. Although periodontal pathogenic bacteria are a common feature of the oral microbiota, they pose a significant risk to persons with a compromised immune system or low WBC count. Levels of bacteria generally peak after tooth extraction. A healthy immune system can eliminate any such bacteria shorty after detection. However, individuals with an abnormally low leucocyte count risk serious infection and may even result in the spread atheromatous plagues into the cardiovascular system (Sastry and Janagond, 2016). Administering antimicrobial drugs during routine tooth extractions for any individual with a low leucocyte count, therefore, seeks to reduce their susceptibility to infection by bacterial colonies

            Prophylaxis would be indicated for a person with a condition such as HIV/AIDs which known for having a negative impact on the immune system. The condition is known for its aggressive nature in destroying leucocytes faster than they can be replenished by the bone marrow (Oswald et al., 2016). Persons with the condition are, therefore, prime candidates for prophylaxis before conducting a routine tooth extraction. It serves as a contingency measure after tooth extraction to reduce the chances of an adverse event where the body is unable to effectively defend itself from emerging infections. Furthermore, prophylaxis increases the probability of positive patient outcomes after an invasive dental procedure among vulnerable populations in the long run.

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