1. 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

2. Contents Introduction Periodontal disease Guidelines pre-surgery
Prevention
Conclusion

3. Introduction

4. 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

5. 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

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

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

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

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

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

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

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

13. 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

14. Prevention Angina Myocardial infarction Arrhythmia
Endocarditis, rheumatic heart disease

15. 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).

16. 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.

17. 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).

18. 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

19. Conclusion
Proper diagnosis and treatment
Regular dental exams

20. Thank you for your listening !