05/27/2026
Q: How should I stress dose for wisdom teeth removal, bone grafts, and crowns?
A: The hydrocortisone coverage depends on whether general anesthesia is needed, the length of time and the likelihood of significant post op pain and stress. If local anesthesia like lidocaine is used for tooth extraction, a double or triple oral dose may be sufficient. If general anesthesia is used for a prolonged surgery, IV hydrocortisone 100 to 200 mg should be given at the start of anesthesia and another dose of 50 mg in the recovery room would be appropriate. In any case, the adrenal insufficiency must be discussed with the dentist or oral surgeon. If an anesthetist or anesthesiologist is assisting, that person is in charge of administering the hydrocortisone and adjusting the dose if needed. -Dr. Margulies, Medical Director of NADF
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