When dental extractions go wrong: teenager suffers cardiac arrest during wisdom tooth extraction

Minnesota: Her family watches on as 17-year-old, Sydney Galleger, struggles for life after experiencing an unexpected cardiac arrest during what can only be described as a routine dental extraction of her wisdom tooth.

“All went good until the very end when her blood pressure shot up and her pulse dropped and then she went into cardiac arrest,” her mother, Diane Galleger, wrote on the CaringBridge web page the family set up to post updates on her condition.

She said the doctor quickly started CPR and called 911, then Sydney “was immediately rushed to the hospital where more doctors and nurses than I could even count, started working on her.” Sydney was stabilized and transferred to the University of Minnesota Masonic Children’s Hospital, but her condition did not improve. The family says she started suffering seizures and was put on a ventilator to help her breathe.

Two days after her dental appointment, Sydney’s brain started to swell dangerously and she had to be taken into surgery to place a drain into her skull to reduce intracranial pressure. Unfortunately, it did not help; the swelling in her brain continued and cut off the drain. Doctors have so far informed the family that there is little more that they can do.

“We want to rewind to Monday where we had our happy, healthy, funny, beautiful 17 year old daughter,” Sydney’s mother wrote in a heartbreaking post on Friday. “As we look at all the pictures covering her hospital walls, we can’t believe this same happy, healthy, funny, still beautiful daughter, sister, granddaughter, niece, cousin, and friend is lying in that hospital bed. We can’t comprehend it yet and not sure when we will.”

CBS Minnesota reports there’s been an outpouring of love and support from the Eden Prairie community, including Sydney’s classmates and lacrosse teammates.

“When I think about it, it just makes me reflect on my own life and my own friends and family,” student Serena Rutledge said. “She really did touch so many lives,” added fellow student Kate Piechowski.

Sydney Galleger’s family says she expressed a wish to become an organ donor if the time ever came, but for now, they continue to hold out hope despite the odds. Though they say the teen meets 9 out of 10 criteria for being considered brain dead, she is able to breathe on her own. “Sydney is a fighter and seems to be upholding that rule right now and is defying the [doctors’] expectations,” her mother wrote Saturday. “She is a fighter. She is still alive.”

Most dental procedures are not life-threatening and thankfully these frightening scenarios are a rarity in the dental field. A study published in 2010 suggested dental work may lead to a very small, short-term increase in risk of what researchers called “vascular events” such as heart trouble or stroke. However, the study only involved data from Medicaid patients, and its findings may not apply to the general population or young, healthy teenagers.

The ‘vascular events’ pointed out maybe due to anxiety, or more commonly due to the affects of epinephrine – which is added as a vasoconstrictor along with the anesthetic agent. The use of epinephrine in dental cartridges is done for two reasons: firstly to prolong the actions of the anesthetic drug and secondly to limit its dissipation into the systemic circulation (by localizing it to the site of action).

Ten million wisdom teeth are extracted in the U.S. each year. While wisdom tooth removal is undoubtedly necessary for some people, many oral surgeons advocate for the removal of the third molars to prevent potential future infections or tooth damage. Yet, studies suggest that less than 12% of wisdom tooth impactions lead to infections or damage to adjacent teeth.

The recent death of Sydney Gallager has now put the necessity of removal of wisdom teeth on a under the spotlight and raised doubts over its routine removal. Many people believe that because getting one’s wisdom teeth out is common, it is safe. In most cases, patients are given unsubstantiated information that might, in some circumstances, invalidate their informed consent of the potential risks of the surgery. Dr. Jay Friedman wrote in the American Journal of Public Health:

“At least two thirds of these extractions, associated costs, and injuries are unnecessary, constituting a silent epidemic of [dentist-induced] injury that afflicts tens of thousands of people with lifelong discomfort and disability,” See the full text of his article: The Prophylactic Extraction of Third Molars: A Public Health Hazard.

Some of the possible risks and dangers in wisdom tooth removal include:

– Risks and potential complications of anesthesia, including heart attack or stroke
– Infection in the extraction site or subsequent stitches
– Lingual nerve damage, which can result in permanent numbness, loss of taste, and other mouth and tongue problems (read more about lingual nerve damage here)
– “Dry socket”, a painful inflammation in the extraction site
– Permanent loss of feeling in the lip, tongue, or cheek which never goes away, ranging from complete numbness to “pins and needles” comparable to when your foot or hand falls asleep
– Bone splinters or root fragments can be left behind in the gum tissue
– Jaw fracture can occur if the surgeon removes part of the bone to access the impacted tooth
– Damage to existing dental work or to the structures of adjacent teeth

(Source: Personal injury law update)

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