Dental and Medical Problems

Dent Med Probl
Index Copernicus (ICV 2021) – 132.50
MEiN – 70 pts
CiteScore (2021) – 2.0
JCI (2021) – 0.5
Average rejection rate (2022) – 79.69%
ISSN 1644-387X (print)
ISSN 2300-9020 (online)
Periodicity – quarterly

Download PDF

Dental and Medical Problems

2019, vol. 56, nr 3, July-September, p. 291–298

doi: 10.17219/dmp/109232

Publication type: review article

Language: English

Download citation:

  • BIBTEX (JabRef, Mendeley)
  • RIS (Papers, Reference Manager, RefWorks, Zotero)

Creative Commons BY-NC-ND 3.0 Open Access

Dental treatment of post-myocardial infarction patients: A review of the literature

Leczenie stomatologiczne pacjentów po przebytym zawale mięśnia sercowego – przegląd piśmiennictwa

Renata Samulak-Zielińska1,A,B,D,F, Elżbieta Dembowska1,D,E,F, Piotr Lizakowski2,B,D,E,F

1 Departament of Periodontology, Pomeranian Medical University in Szczecin, Poland

2 Specialist Medical Practice in Szczecin, Poland

Abstract

Patients who have suffered a heart attack often require dental treatment. The inflammation of the oral cavity not only reduces the quality of life, but also negatively affects the course of ischemic heart disease. Dental treatment in patients with a history of myocardial infarction seems complicated, since these patients require special consideration with regard to the timing and form of dental treatment as well as to the precautions required. Patients at risk of cardiac complications that are greater than the benefits of dental treatment should be identified and only the most urgent conditions should be treated. The aim of this study was to present the latest guidelines for dental treatment in patients who have suffered myocardial infarction. We reviewed the available literature explaining when dental treatment can be undertaken, whether antibiotic prophylaxis is required, whether the patient can be anesthetized locally, and how to provide the maximum safety during the visit. The principles of the surgical treatment of patients receiving drugs that affect hemostasis were also reviewed.

Key words

dental care, oral anticoagulants, antibiotic prophylaxis, myocardial infarction

Słowa kluczowe

opieka stomatologiczna, doustne antykoagulanty, profilaktyka antybiotykowa, zawał mięśnia sercowego

References (38)

  1. Bhateja S. High prevalence of cardiovascular diseases among other medically compromised conditions in dental patients: A retrospective study. J Cardiovasc Dis Res. 2012;3(2):113–116.
  2. Włosowicz M, Wozakowska-Kapłon B, Górska R. Periodontitis in relation to selected parameters of cardiovascular system in the group of patients with acute myocardial infarction [in Polish]. Czas Stomatol. 2012;65(5):636–653.
  3. Chaudhry S, Jaiswal R, Sachdeva S. Dental considerations in cardiovascular patients: A practical perspective. Indian Heart J. 2016;68(4):572–575.
  4. Kebschull M, Demmer RT, Papapanou PN. “Gum bug, leave my heart alone!” – epidemiologic and mechanistic evidence linking periodontal infections and atherosclerosis. J Dent Res. 2010;89(9):879–902.
  5. Cruz-Pamplona M, Jimenez-Soriano Y, Sarrión-Pérez MG. Dental considerations in patients with heart disease. J Clin Exp Dent. 2011;3(2):e97–e105.
  6. Górski B, Włosowicz M, Dembowska E, Kręgielczak A, Górska R. More than 40% patients after cardiac infarct require immediate application of specialist periodontal treatment [in Polish]. Magazyn Stomatol. 2014;24(1):95–98.
  7. Napeñas JJ, Kujan O, Arduino PG, et al. World Workshop on Oral Medicine VI: Controversies regarding dental management of medi­cally complex patients: Assessment of current recommendations. Oral Surg Oral Med Oral Pathol Oral Radiol. 2015;120(2):207–226.
  8. Pedersen F, Butrymovich V, Kelbæk H, et al. Short- and long-term cause of death in patients treated with primary PCI for STEMI. J Am Coll Cordial. 2014;64(20):2101–2108.
  9. Thygesen K, Alpert JS, Jaffe AS, Simoons ML, Chaitman BR, White HD. Third universal definition of myocardial infarction. Circulation. 2012;126(16):2020–2035.
  10. Research, Science and Therapy Committee, American Academy of Periodontology. Periodontal management of patients with cardiovascular diseases. J Periodontol. 2002;73(8):954–968.
  11. Niwa H, Sato Y, Matsuura H. Safety of dental treatment in patients with previously diagnosed acute myocardial infarction or unstable angina pectoris. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2000;89(1):35–41.
  12. Roberts HW, Mitnitsky EF. Cardiac risk stratification for postmyocardial infarction dental patients. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2001;91(6):676–681.
  13. Silvestre FJ, Miralles-Jorda L, Tamarit C, Gascon R. Dental management of the patient with ischemic heart disease: An update. Med Oral. 2002;7(3):222–230.
  14. Napora M. Antibiotics prophylaxis for patients at high risk of infectious endocarditis [in Polish]. Nowa Stomatol. 2008;13(1):24–26.
  15. Habib G, Lancellotti P, Antunes MJ, et al. ESC guidelines for the treatment of infective endocarditis in 2015 [in Polish]. Kardiol Pol. 2015;73(11):963–1027.
  16. Kaczmarzyk T, Babiuch K, Bołtacz-Rzepkowska E, et al. Rekomendacje Grupy Roboczej Polskiego Towarzystwa Stomatologicznego i Narodowego Programu Ochrony Antybiotyków w zakresie stosowania antybiotyków w stomatologii. Warsaw, Poland: Narodowy Instytut Leków; 2019.
  17. Roberts HW, Redding SW. Coronary artery stents: Review and patient-management recommendations. J Am Dent Assoc. 2000;131(6):797–801.
  18. AAE Quick Reference Guide: Antibiotic Prophylaxis 2017 Update. https://www.aae.org/specialty/wp-content/uploads/sites/2/2017/06/aae_antibiotic-prophylaxis-2017update.pdf
  19. Kaura A, Dworakowska D, Dworakowski R. Infective endocarditis – Cinderella in cardiology. Kardiol Pol. 2017;75(10):965–974.
  20. Wilson W, Taubert KA, Gewitz M, et al.; American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee; American Heart Association Council on Cardiovascular Disease in the Young; American Heart Association Council on Clinical Cardiology; American Heart Association Council on Cardiovascular Surgery and Anesthesia; Quality of Care and Outcomes Research Interdisciplinary Working Group. Prevention of infective endocarditis: Guidelines from the American Heart Association: A guideline from the American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee, Council on Cardiovascular Disease in the Young, and the Council on Clinical Cardiology, Cou
  21. Rose LF, Mealey B, Minsk L, Cohen DW. Oral care for patients with cardiovascular disease and stroke. J Am Dent Assoc. 2002;133(Suppl):37S–44S.
  22. Laragnoit AB, Neves RS, Neves ILI, Vieira JE. Locoregional anesthesia for dental treatment in cardiac patients: A comparative study of 2% plain lidocaine and 2% lidocaine with epinephrine (1:100,000). Clinics (Sao Paulo). 2009;64(3):177–182.
  23. Margaix Muñoz M, Jiménez Soriano Y, Poveda Roda R, Sarrión G. Cardiovascular diseases in dental practice. Practical considerations. Med Oral Pathol Oral Cir Bucal. 2008;13(5):E296–E302.
  24. Vanderheyden PJ, Williams RA, Sims TN. Assessment of ST segment depression in patients with cardiac disease after local anesthesia. J Am Dent Assoc. 1989;119(3):407–412.
  25. Daskalov H, Dinkova A, Drangov M. Local anesthetics in patients with cardiovascular diseases. J of IMAB. 2015;21(1):728–731.
  26. Elad S, Admon D, Kedmi M, et al. The cardiovascular effect of local anesthesia with articaine plus 1:200,000 adrenalin versus lidocaine plus 1:100,000 adrenalin in medically compromised cardiac patients: A prospective, randomized, double-blinded study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008;105(6):725–730.
  27. Skaar D, O’Connor H, Lunos S, Luepker R, Michalowicz BS. Dental procedures and risk of experiencing a second vascular event in a Medicare population. J Am Dent Assoc. 2012;143(11):1190–1198.
  28. Valgimigli M, Bueno H, Byrne RA, et al.; ESC Scientific Document Group; ESC Committee for Practice Guidelines (CPG); ESC National Cardiac Societies. 2017 ESC focused update on dual antiplatelet therapy in coronary artery disease developed in collaboration with EACTS: The Task Force for dual antiplatelet therapy in coronary artery disease of the European Society of Cardiology (ESC) and of the European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J. 2018;39(3):213−260.
  29. Levine GN, Bates ER, Bittl JA, et al. 2016 ACC/AHA guideline focused update on duration of dual antiplatelet therapy in patients with coronary artery disease: A report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Thorac Cardiovasc Surg. 2016;152(5):1243–1275.
  30. Pruszczyk P, Ciurzyński M, Opolski G, et al. Dental cardio common position for dealing anticoagulation in patients undergoing dental procedures [in Polish]. Kardiol Pol. 2016;74(1):87–98.
  31. Gziut AI. Late in-stent thrombosis as a cause of acute coronary syndrome complicated by out-of-hospital cardiac arrrest [in Polish]. Kardiol Pol. 2008;66(6):697–699.
  32. Dodson T. Should acetylsalicylic acid (ASA) therapy for prevention of thromboembolic events be stopped prior to surgical extractions? Evid Based Dent. 2012;13(3):89–90.
  33. Park MW, Her SH, Kwon JB, et al. Safety of dental extractions in coronary drug-eluting stenting patients without stopping multiple antiplatelet agents. Clin Cardiol. 2012;35(4):225–230.
  34. Buhatem Medeiros F, Pepe Medeiros de Rezende N, Bertoldi Franco J, et al. Quantification of bleeding during dental extraction in patients on dual antiplatelet therapy. Int J Oral Maxillofac Surg. 2017;46(9):1151–1157.
  35. Singh S, Gupta K, Garg KN, Fuloria NK, Fuloria S, Jain T. Dental management of the cardiovascular compromised patient: A clinical approach. J Young Pharm. 2017;9(4):453–456.
  36. Milczarek S, Smektała T, Jędrzejewski M, Szyndel J, Sporniak-Tutak K. Dental procedures in patients with coexistent blood clotting disorder or arterial hypertension. Pt 2. Procedure with patients taking oral anticoagulants or modern anticoagulants [in Polish]. Magazyn Stomatol. 2013;23(12):116–118.
  37. Pototski M, Amenábar JM. Dental management of patients receiving anticoagulation or antiplatelet treatment. J Oral Sci. 2007;49(4):253–258.
  38. Dézsi CA, Dézsi BB, Dézsi AD. Management of dental patients receiving antiplatelet therapy or chronic oral anticoagulation: A review of the latest evidence. Eur J Gen Pract. 2017;23(1):196–201.
© Wroclaw Medical University