When treating patients suffering from cardiopathy, dentists have to be careful.
It is essential to inquire about the type of cardiopathy, medication, surgery, etc.
Therefore, the practitioner can follow the proper protocol.
1.Patients with cardiopathy can be divided into two groups. This classification is based on the risk of developing infective endocarditis:
Group A: High risk:
Valvular prosthesis
Cyanotic cardiopathy
History of endocarditis
Group B: Lower risk:
Valvulopathy
Acyanotic cardiopathy
Hypertrophic cardiomyopathy
Poor dental health increases the risk of a bacterial infection in the bloodstream, which can affect the heart valves.
Thus, dental infections need to be treated properly and quickly to avoid infective endocarditis.
Antibiotics have to be prescribed before dental treatment.
Some dental interventions are prohibited for patients at risk of developing infective endocarditis:
Root amputation-transplantation-Reimplantation-Periodontal surgery-Endodontic surgery-Implants-Bone graft-Endodontic retreatment-Necrotic pulp treatment
2.For patients on blood thinners, there are multiple risks during dental treatment.
Tips:
-The inferior alveolar nerve block is prohibited to avoid thrombosis
-An INR (International normalized ratio) must be requested. It evaluates the clotting potential.
3.If the patient is on antiplatelet drugs, the bleeding risk can not be evaluated.
The dentist must be prepared to manage the bleeding.
It can be controlled by the application of direct pressure, hemostatic agents, and sutures.
Anti-clotting medication must never be stopped. These drugs prevent strokes which are more dangerous and life-threatening than bleeding.
4.Patients treated with calcium channel blockers may have gum hypertrophy. In this case, consulting the treating practitioner to modify the medication or gum surgery may be necessary.
5.For patients with a previous heart attack or angina, oxygen and nitroglycerin must be available in case of a medical emergency.
