Cardiac Patients in the Dental Clinic

Cardiac patients should not be treated like normal patients in the  dental clinic.

There are special Precautions that should be taken to avoid any complications during, and after the dental procedure.

Generally, precautions and special considerations are necessary in patients with certain medical conditions. You may consult with your physician or speak to the oral surgeon for specific recommendations.


Heart Disease:
Patients with a history of heart attacks, chest pains, enlarged hearts, arrhythmia, and valve disease may require special precautions. 

• First, it is important to have a proper physical exam by your doctor to make sure your condition is stable. 
• You may continue all of your medications without change throughout your treatment. 
• Patients who have had a heart attack (myocardial infarction) may have elective oral surgery after six months to minimize risks. However, with a good functional status, necessary oral surgical procedures may be done between six weeks and three months without undue added risk.
• Local anesthesia with epinephrine is used with caution and limited dosage in patients with cardiovascular disease.
• Sedation is highly recommended to minimize stress on a patient’s heart while providing continued monitoring and supplemental oxygen. 
• Your oral surgeon may consult with your doctor for other necessary precautions.

Heart Murmurs:

• Patients with heart valve disease may require antibiotic prophylaxis prior to surgery to prevent bacterial endocarditis.
• High-risk patients requiring antibiotics include those with artificial heart valves, a history of prior infective endocarditis, certain congenital heart conditions, constructed shunts, any repaired congenital defects with prosthetic valves or devices, and cardiac transplant with valve problems. 
• Antibiotics are no longer necessary for patients with mitral valve prolapse, rheumatic heart disease, bicuspid valve disease, calcified aortic stenosis, congenital heart conditions such as ventricular septal defect, atrial septal defect, and hypertrophic cardiomyopathy.

*Reference: 2007, Council on Cardiovascular Surgery and Anesthesia, and the Quality of Care and Cardiovascular Disease in the Young, and the Council on Clinical Cardiology, Fever, Endocarditis, and Kawasaki Disease Committee, Council on Association: A Guideline From the American Heart Association Rheumatic Prevention of Infective Endocarditis: Guidelines From the American Heart Association.

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