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The heart of it: dental care and cardiothoracic surgery

British Dental Journal volume 237, pages 33–39 (2024)Cite this article

Abstract

Both dental and cardiovascular disease are prevalent in the general population, have common risk factors and may be closely associated.

Following cardiothoracic surgery, patients may be higher risk for developing infective endocarditis (IE) than the general population. Before cardiothoracic interventions, it is common practice for a dental assessment to be carried out and any necessary dental treatment provided. This aims to reduce the risk of IE arising from dental sources and avoid dental pain or infection during the peri- and post-operative period. There is little guidance on which treatments should be performed and when.

Many patients with cardiac disease may have dental treatment provided safely in primary care. However, there is often a need to consider additional factors, including bleeding risk, condition stability or medication interactions. Dental teams must have an awareness of the implications of cardiac disease and provide reasonable adjustments to care provision where necessary, ensuring patient safety.

This article proposes a protocol for dental management of patients awaiting cardiothoracic surgery and explores important considerations for dental care in this patient group.

Key points

  • Oral and cardiac diseases are common and can be associated with each other.

  • Dental care to reduce oral infection risk is integral to pre-operative planning for cardiac surgery, particularly valve replacement and where prosthetic material will be used.

  • Awareness of the consequences of cardiac diseases for dental intervention is necessary to provide safe dental care.

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Acknowledgements

Kathryn Jorgenson, collaborating author for a first draft of this work, provided insights relating to paediatric dentistry which have not been included in the final manuscript submitted.

Funding

Louise Coates receives research funding from British Heart Foundation and NIHR, is collaborating with Cardiacsense on a research project and has paid associate work with Mantrasystems (regulatory).

Author information

Authors and Affiliations

  1. Community Dental Officer, Newcastle upon Tyne Hospitals NHS Foundation Trust, Community Dental Services, Molineux Street NHS Centre, Byker, Newcastle upon Tyne, NE6 1SG, UK

    Claire Potter

  2. Locum Community Dental Officer, Newcastle upon Tyne Hospitals NHS Foundation Trust, Community Dental Services, Molineux Street NHS Centre, Byker, Newcastle upon Tyne, NE6 1SG, UK

    Zoe Ritson

  3. Consultant in Special Care Dentistry, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle Dental Hospital, Richardson Road, Newcastle upon Tyne, NE2 4AZ, UK

    Graham Walton

  4. Consultant in Adult Congenital Heart Disease, Newcastle upon Tyne Hospitals NHS Foundation Trust, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, NE1 7RU, UK

    Louise Coats

  5. Consultant Cardiologist, Newcastle upon Tyne Hospitals NHS Foundation Trust, Freeman Hospital, Freeman Road, High Heaton, Newcastle upon Tyne, NE7 7DN, UK

    Tim Irvine

  6. Specialty Doctor in Oral and Maxillofacial Surgery, Arrowe Park Hospital, Arrowe Park Road, Arrowe Park, Upton, Wirral, CH49 5PE, UK

    Kate Ohlsen-Turner

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Contributions

Claire Potter: first author (majority of work in collaboration with Zoe Ritson). Zoe Ritson: second author (majority of work in collaboration with Claire Potter). Tim Irvine: author of section about percutaneous transcatheter procedures, provided guidance and proofreading. Kate Ohlson-Turner: collaborating author for a first draft of this work, providing insights relating to oral surgery. Graham Walton and Louise Coats: provided guidance and proofreading.

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Correspondence to Zoe Ritson.

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Potter, C., Ritson, Z., Walton, G. et al. The heart of it: dental care and cardiothoracic surgery. Br Dent J 237, 33–39 (2024). https://doi.org/10.1038/s41415-024-7558-6

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