{"id":1013,"date":"2019-08-19T15:01:36","date_gmt":"2019-08-19T15:01:36","guid":{"rendered":"http:\/\/www.jpeterstclairdentistry.com\/blog\/?p=1013"},"modified":"2019-08-19T15:01:37","modified_gmt":"2019-08-19T15:01:37","slug":"new-info-for-cardiac-patients","status":"publish","type":"post","link":"https:\/\/www.jpeterstclairdentistry.com\/blog\/new-info-for-cardiac-patients\/","title":{"rendered":"NEW INFO FOR CARDIAC PATIENTS"},"content":{"rendered":"\n
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It is common sense that infected teeth, whether they hurt or not, or are\nbroken down beyond repair, should be removed. We also all know by now that\nthere are mouth-body connections and that the mouth is the \u201cgateway\u201d to the\nrest of the body. There is no disputing that a healthy mouth is better for you\non many levels. However, in a recently released study, the guidelines for\ntreatment of some types of dental problems prior to specific surgery need\ncloser consideration.<\/p>\n\n\n\n

According to a study in an issue of The Annals of Thoracic Surgery<\/em>,\nremoving an infected tooth prior to cardiac surgery may increase the risk of\nmajor adverse outcomes, including risk of death prior to surgery. This is a very\nspecific study for a very specific group of patients. It does suggest considering\npostponing dental problems prior to any surgery.<\/p>\n\n\n\n

Dental extraction of abscessed or infected teeth is often performed to\ndecrease the risk of infection during surgery and endocarditis (an inflammation\nof the inner layer of the heart) following surgery. In this particular study,\nphysician researchers evaluated the occurrence of major adverse outcomes in 205\npatients who underwent at least one dental extraction prior to planned cardiac\nsurgery. The median time from dental extraction to cardiac surgery was 7 days\n(average 35 days). <\/p>\n\n\n\n

One of the researchers explained, \u201cGuidelines from the American College\nof Cardiology and American Heart Association label dental extraction as a minor\nprocedure, with the risk of death or non-fatal heart attack estimated to be\nless than 1%. Our results, however, documented a higher rate of major adverse\noutcomes, suggesting physicians should evaluate individualized risk of\nanesthesia and surgery in this patient population.\u201d<\/p>\n\n\n\n

In this study, patients who underwent dental extraction prior to cardiac\nsurgery experienced an 8% incidence of major adverse outcomes, including new\nheart attack, stroke, kidney failure and death. Overall, 3% of patients died after\ndental extraction and before the planned cardiac surgery could be performed.\nAnother of the researchers went on to say, \u201cWith the information from our study\nwe cannot make a definitive recommendation for or against dental extraction\nprior to cardiac surgery. We recommend an individualized analysis of the\nexpected benefit of dental extraction prior to surgery weighed against the risk\nof morbidity and mortality as observed in our study.\u201d<\/p>\n\n\n\n

This study, as in many \u201cnew\u201d studies, awakens us to consider a departure\nfrom current lines of thinking about specific situations. This paradigm shift\nof thinking has also been noted in the use of prophylactic antibiotics prior to\ndental procedures in those with cardiac conditions.<\/p>\n\n\n\n

Prophylactic antibiotics have routinely been prescribed for patients\nundergoing dental work who also had existing heart problems because it had been\naccepted that there is a link between dental bacteremia and endocarditis.\nIndividuals with pre-existing heart problems tend to have a higher incidence of\nendocarditis. The American Heart Association and others have withdrawn support\nfor this practice of prophylactic antibiotics because the danger from overuse\nof antibiotics outweighs any other potential risks. Regular tooth brushing,\nflossing, and even chewing gum are now recognized to dislodge as much, if not\nmore, bacteremia than most dental procedures.<\/p>\n\n\n\n

Prevention of dental problems is the best line of defense. Regular\nprofessional maintenance, especially as we age, is important to our overall\nhealth. Talk with your dentist and physician about your specific situations. <\/p>\n\n\n\n

Dr. St. Clair maintains\na private dental practice in Rowley and Newburyport dedicated to health-centered\nfamily dentistry. If there are certain topics you would like to see written about\nor questions you have please email them to him at jpstclair@stclairdmd.com<\/a>.\nYou can view all previously written columns at www.jpeterstclairdentistry.com\/blog<\/a>.<\/p>\n","protected":false},"excerpt":{"rendered":"

It is common sense that infected teeth, whether they hurt or not, or are broken down beyond repair, should be removed. We also all know by now that there are mouth-body connections and that the mouth is the \u201cgateway\u201d to the rest of the body. There is no disputing that a healthy mouth is better for you on many levels. However, in a recently released study, the guidelines for treatment of some types of dental […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-1013","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"_links":{"self":[{"href":"https:\/\/www.jpeterstclairdentistry.com\/blog\/wp-json\/wp\/v2\/posts\/1013","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.jpeterstclairdentistry.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.jpeterstclairdentistry.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.jpeterstclairdentistry.com\/blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.jpeterstclairdentistry.com\/blog\/wp-json\/wp\/v2\/comments?post=1013"}],"version-history":[{"count":2,"href":"https:\/\/www.jpeterstclairdentistry.com\/blog\/wp-json\/wp\/v2\/posts\/1013\/revisions"}],"predecessor-version":[{"id":1018,"href":"https:\/\/www.jpeterstclairdentistry.com\/blog\/wp-json\/wp\/v2\/posts\/1013\/revisions\/1018"}],"wp:attachment":[{"href":"https:\/\/www.jpeterstclairdentistry.com\/blog\/wp-json\/wp\/v2\/media?parent=1013"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.jpeterstclairdentistry.com\/blog\/wp-json\/wp\/v2\/categories?post=1013"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.jpeterstclairdentistry.com\/blog\/wp-json\/wp\/v2\/tags?post=1013"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}