What should dentists know about their patients with heart disease? Group7 黃凱仁 陳彥廷 林晉宇 廖家祥 吳拓 林益賢

Contents Introduction Periodontal disease Guidelines pre-surgery Prevention Conclusion

Introduction

Periodontitis a set of inflammatory diseases affecting the periodontium caused by microorganisms that adhere to and grow on the tooth's surfaces, along with an over-aggressive immune response against these microorganisms

Management Nonsurgical cleaning: removal of microbial plaque and calculus by scaling and debridement Surgery: definitive calculus removal and surgical management of bony irregularities which have resulted from the disease process to reduce pockets as much as possible

What should dentists know? have recently had heart surgery have heart disease have suffered a heart attack angina(chest pain)

Angina(chest pain) stable angina unstable angina drugs (calcium channel blocker)gingival hyperplasia

Recommend reduce stress 1. sleeping well 2. avoiding caffeine bring medications

Congestive heart failure Systolic malfunction (inability for the heart to contract) Diastolic malfunction (inability for the heart to relax)

Recommend Hospital clinic should not stay lying down too long Having a slower movement

Medication Many medications prescribed to treat congestive heart failure may cause xerostomia (dry mouth)

Infective endocarditis infection of the heart valves. bacteria or other micro-organisms enter the body and reach the heart

Guidelines in Treatment of Cardiovascular Patients A proper assessment Good communication Premedication should be considered to relieve nervousness Terminate any procedure if the patient is overly anxious Be prepared for emergencies

Prevention Angina Myocardial infarction Arrhythmia Endocarditis, rheumatic heart disease

Angina consultation to the patient's physician . minimize patient’s anxiety before, during and after the treatment. Prepare NTG tablets or spray, use it or not is depending on the situation before treatment. Prepare oxygen, as the case may be used in therapy. Make sure the depth of anesthesia is enough for therapy. Consider row nitrous oxide calm. maintaining communication with the patient treatment, pay attention to the patient’s signs of life. Limitation Epinephrin used in 0.04mg or less. (4ml in 1: 100,000).

Myocardial infarction Note whether patients taking anticoagulants. myocardial infarction is not suitable for any dental treatment within six months, because the recurrence rate is very high. In case of emergency dental referral is recommended to large institutions.

Arrhythmia Arrhythmia patients often take anticoagulants or have a pacemaker, the one who has heart rate regulator patients should not use the electric shock. 0.04mg limit Epinephrin used in the following. (4ml in 1: 100,000).

Endocarditis, rheumatic heart disease Valvular heart is the reason of endocarditis Examples: Artificial valves, congenital heart defects, rheumatic heart disease, valvular heart degradation, aortic sclerosis, mitral regurgitation and prolapse do, endocarditis patients For these patients, the dentists should give prophylactic antibiotic treatment like Amoxicillin when doing dental invasive treatment

Conclusion Proper diagnosis and treatment Regular dental exams

Thank you for your listening !