Perioperative Dental Evaluation

Yasny, Jeffrey S.; Herlich, Andrew

doi:10.1002/msj.21292

Cited by 14 publications

(19 citation statements)

References 68 publications

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“…As a result, 41 studies met the inclusion criteria, and an additional three papers were included after checking the references of the relevant selected reviews and studies (see Table 1). 12–54…”

Section: Resultsmentioning

confidence: 99%

The perioperative dental screening and management of patients undergoing cardiothoracic, vascular surgery and other cardiovascular invasive procedures: A systematic review

Cotti

Arrica

Lenarda

et al. 2017

Eur J Prev Cardiolog

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Background One controversial issue in the relationship between oral care and cardiovascular diseases is how and whether to manage oral infections prior to cardiovascular surgery or other cardiovascular invasive procedures. Design We designed a systematic review to assess the information available on three main questions. Is there an agreement on the need for dental evaluation and treatment before cardiovascular interventions? Are consistent clinical recommendations or protocols available? Is dental treatment prior to cardiovascular interventions effective? Methods A systematic electronic search of MEDLINE, Scopus and Web of Science was performed from the database inceptions up to 31 April 2016. Searches were performed using Boolean operators to combine medical subject headings and free text words. Because this review included a large, heterogeneous group of study designs and sources, the results were synthesised in a narrative approach. Results In total, 2447 studies were identified: 2099 (+241 duplicates) were excluded after screening; 107 were included for full-text assessment; 55 were excluded for not meeting the inclusion criteria; and 11 were not available. Thus, 44 studies meeting the inclusion criteria were analysed. We found that, for patients undergoing cardiovascular surgery, there is a general agreement on the need for screening and treatment of dental infections, but not on the protocols. We also found that there are conflicting indications on when and to what extent to perform the treatment and that the risk-to-benefit ratios for these treatments are controversial. Conclusion No satisfactory answers regarding dental care before cardiovascular invasive procedures are available.

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Section: Resultsmentioning

confidence: 99%

The perioperative dental screening and management of patients undergoing cardiothoracic, vascular surgery and other cardiovascular invasive procedures: A systematic review

Cotti

Arrica

Lenarda

et al. 2017

Eur J Prev Cardiolog

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“…Recommendations on antibiotic prophylaxis against infective endocarditis have changed dramatically over the past ten years, 9,10,12 and the relationship between a patient's dentition and overall systemic health has been studied extensively. 13 The inclusion of a preoperative dental examination has been used effectively in surgical procedures, 13 but little data are available on the oral health of children with congenital heart disease, especially those from a developing country.…”

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confidence: 99%

Caries experience in young children with congenital heart disease in a developing country

et al. 2013

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Oral care is frequently suboptimal in children from developing countries, especially those suffering from severe systemic diseases. The aim of the present study was to analyze the oral epidemiological profile of 3-to-5-year-old children with congenital heart disease. Dental and medical records of children evaluated at the Dental Service of the National Institute of Cardiology, Rio de Janeiro, Brazil, were reviewed. Caries experience was reported using the dmft index. Negative behavior towards dental management was recorded. The sample consisted of 144 children aged 4.41 ± 0.95 years. The mean dmft value was 5.4 ± 4.9, and 80.5% had at least one caries lesion. Dmft index was greater in the presence of cyanotic cardiac disease and in children with negative behavior. An increase in the "missing" component of the dmft index was also found in children using medicine on a daily basis. A higher caries experience was associated with children whose fathers had only an elementary education. In conclusion, children with congenital heart disease had high levels of caries experience at a young age. Cyanosis, negative behavior, daily use of medicine, one-parent family and the educational level of fathers seem to influence caries experience in children with congenital cardiac disease.

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“…Cancellations of paediatric cardiac procedures due to poor oral health results in delay of needed interventions, thereby increasing risk of morbidity and mortality, 9 and may create a substantial hardship for the patient and family. Unexpected cancellations create inefficiencies in healthcare delivery which increases resource and labour costs.…”

Section: Discussionmentioning

confidence: 99%

“…This was a mini-cycle improvement quality project of 14 weeks. Due to the small number of referrals per week (n = [1-6]) (Appendix 2), and the small number of total referrals per provider over the intervention period (n = [1][2][3][4][5][6][7][8][9][10]), overall adherence rates were easily skewed week-to-week by the performance of a single provider. For this reason, the adherence of all providers was calculated together as an average, to determine the success of the intervention.…”

Section: Limitationsmentioning

confidence: 99%

Implementation of a standardized oral screening tool by paediatric cardiologists

et al. 2020

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Background: An examination of invasive procedure cancellations found that the lack of pre-procedural oral screening was a preventable cause, for children with congenital heart disease. The purpose of this study was to implement an oral screening tool within the paediatric cardiology clinic, with referral to paediatric dental providers for positive screens. The target population were children aged ≥6 months to <18 years old, being referred for cardiac procedures. Methods: The quality implementation framework method was used for this study design. The multi-modal intervention included education, audit and feedback, screening guidelines, environmental support, and interdisciplinary collaboration. Baseline rates for oral screenings were determined by retrospective chart audit from January 2018 to January 2019 (n = 211). Provider adherence to the oral screening tool was the outcome measure. Positive oral screens, resulting in referral to the paediatric dental clinic, were measured as a secondary outcome. Provider adherence rates were used as a process measure. Results: Data collected over 14 weeks showed a 29% increase in documentation of oral screenings prior to referral, as compared to the retrospective chart audit. During the study period, 13% of completed screenings were positive (n = 5). Provider compliance for the period was averaged at 70% adherence. Conclusion: A substantial increase in pre-procedural oral screenings by paediatric cardiologists was achieved using the quality implementation framework and targeted interventions.

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Perioperative Dental Evaluation

Cited by 14 publications

References 68 publications

The perioperative dental screening and management of patients undergoing cardiothoracic, vascular surgery and other cardiovascular invasive procedures: A systematic review

The perioperative dental screening and management of patients undergoing cardiothoracic, vascular surgery and other cardiovascular invasive procedures: A systematic review

Caries experience in young children with congenital heart disease in a developing country

Implementation of a standardized oral screening tool by paediatric cardiologists

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