Periodontal
Management of Patients with Cardiovascular Diseases
Back to the index (top of page)
Periodontists are often
called upon to provide periodontal therapy for patients with a variety
of cardiovascular diseases. Cardiovascular
diseases affect approximately 43 million people in the United States
today. They afflict more
Americans than any other category of serious disease. Some cardiac
conditions require antibiotics before dental treatment.
Cardiac
Conditions Requiring Antibiotic Prophylaxis
Prosthetic cardiac valves, including bioprosthetic and homograft valves.
Previous infective endocarditis, even in the absence of heart disease
Most congenital cardiac malformations
Rheumatic and other acquired valvular dysfunction even after valvular surgery
Hypertrophic cardiomyopathy
Mitral valve prolapse with valvular regurgitation
Isolated
secundrum atrial septal defect
Surgical
repair without residue beyond 6 months of secundrum atrial septal
defect, ventricular defect, or patent ductus arteriosus
Previous
coronary artery bypass graft surgery
Mitral
valve prolapse without vavular regurgitation
Physiologic,
functional, or innocent heart murmurs
Previous
rheumatic fever without valvular dysfunction
Previous
Kawasaki disease without valvular dysfunction
Cardiac
pacemakers and implanted defibrillators
Back to the index (top of page)
Hypertension
High blood pressure is the major risk factor for cardiovascular disease and a major cause of renal failure and stroke. It affects 15 to 20% of adults in the United States. A blood pressure reading of >160/95 mm Hg is generally considered to represent hypertension for an adult. A reading between 140/90 mm Hg and 160/95 mm Hg is borderline hypertension. Some authorities, however, define hypertension at varying blood pressure levels according to the patient’s age, sex, and race. The prevalence of hypertensive heart disease increases sharply with age.
Dental
health care workers can have an important role in detection and
management of hypertensive patients.
These patients should be advised to seek medical consultation.
There are no contraindications, however, to providing dental care
for the well-controlled hypertensive patient.