Patients with cardiac disease: considerations for the dental practitioner

Abstract

The provision of dental treatment under both local anaesthesia and sedation has an excellent safety record, although medical problems may occur. The high prevalence of cardiac disease in the population, particularly ischaemic heart disease, makes it the most common medical problem encountered in dental practice. Additionally, the increasing survival of children with congenital heart disease makes them a significant proportion of those attending for dental treatment. While most dental practitioners feel confident in performing cardio-pulmonary resuscitation, treating patients with co-existent cardio-vascular disease often causes concern over potential problems during treatment. This article aims to allay many of these fears by describing the commoner cardiac conditions and how they may affect dental treatment. It outlines prophylactic and remediable measures that may be taken to enable safe delivery of dental care.

Endocarditis prophylaxis and congenital heart defects in the Norwegian Public Dental Service

“…Also the finding that many felt less confident when treating children with CHD compared with treating otherwise healthy children is in accordance with the literature . The finding that a quarter of the dentists in the present study responded that they used more treatment time with CHD patients compared with healthy children might be an additional facet of the same insecurity.…”

“…This means that a significant number of children and adolescents with CHD are taken care of in dental practice. It is therefore a reason for concern that studies have revealed that dentists feel uncertain and insecure about treatment for children with CHD . Parents of children with severe CHD have also reported to be less satisfied with their reception at public dental clinics compared with the parents of healthy children .…”

Internistische Risikofaktoren bei der implantatprothetischen Behandlung

“…Nach einem Herzinfarkt oder dem Einsetzen eines Herzklappenersatzes sollten chirurgische Eingriff e innerhalb des 1. Jahres nur nach strenger Indikationsstellung erfolgen [10]. Bei einigen Patienten kann eine Dauertherapie mit Antikoagulantien zur Verhinderung thromboembolischer Komplikationen indiziert sein [6].…”

Endocarditis Prophylaxis in Cardiac Patients: Knowledge among General Dental Practitioners in Tabriz

“…1 , 2 This can lead to infection of sterile vegetations on cardiac valves in susceptible patients to endocarditis. 3 Fiehn et al 4 showed that in patients with infectious endocarditis, Streptococci strains isolated from the blood sample were similar to bacteria collected from the oral cavity. …”