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.
Highlights
The number of patients with general diseases requiring dental treatment is on the increase
The inflammation of the oral cavity reduces the quality of life, and negatively affects the course of ischemic heart disease
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
Summary
The number of patients with general diseases requiring dental treatment is on the increase. There is an increase in the level of pro-inflammatory mediators in response to the presence of Gram-negative lipopolysaccharides (LPSs), C-reactive protein (CRP), interleukin 1β and interleukin 6 (IL-1β and IL-6), tumor necrosis factor alpha (TNF-α), fibrinogen, and matrix metalloproteinase 9 (MMP-9). These substances contribute to the destabilization of the atherosclerotic plaque.[2] Secondly, there is a cross-reaction of the patient’s antibodies with heat shock protein (HSP) present in the damaged vascular endothelium and atherosclerotic plaques. This results in a need for treatment of oral cavity diseases as well as in intensive efforts toward periodontal disease prevention in patients with cardiovascular diseases.[5]
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