Treatment FAQ

at a dentist visit what are implications for treatment a patient with a heart murmur

by Miss Andreanne Cruickshank Published 3 years ago Updated 2 years ago

A heart murmur is a prevalent finding in dental patients. It is of major concern because certain dental procedures occasionally can induce severe cardiovascular complications. Murmurs may indicate existing heart disease that is a risk factor for infective endocarditis (IE) following a dental procedure, as well as more severe heart conditions.

Full Answer

Can I go to the dentist with a heart murmur?

Not exclusively will your dental specialist examine their involvement with or without the utilization of anti-toxins before dental work procedure, however, they will need to know the information concerning your heart murmur as well as the major cause. This gives a way out to deal with a heart murmur during dental work.

How to maintain oral wellbeing for people with heart murmur?

Great oral wellbeing is essential for everybody, in specific anybody a heart murmur needs to give careful consideration to brushing and daily flossing. Keeping a regular checkup with a dental practitioner is advisable. In case of any dental issues, they have to addressed earlier to reduce the chances of bacteria getting into the bloodstream.

Do I need antibiotics for a heart murmur before a dental procedure?

There are many other causes of heart murmurs, but they are considered by the American Heart Association to carry a much lower risk of infective endocarditis and may not require the use of antibiotics prior to a dental procedure.

Do I need surgery for a heart murmur?

Surgery may be needed to correct a damaged or leaky valve that causes a heart murmur. Depending on your heart condition, your doctor may recommend one of several heart valve treatment options.

Can you go to the dentist with a heart murmur?

For years, the AHA recommended that people with most heart problems, including murmurs, take a short-term course of antibiotics before visiting the dentist. The goal was to reduce the risk for infective endocarditis, an infection of the heart's lining or valves that could be caused by oral bacteria.

Can you be put under anesthesia with a heart murmur?

It is therefore imperative to reach a complete cardiac diagnosis rather than to settle for a "diagnosed" murmur as reason enough to avoid general anesthesia, especially when non-elective procedures are considered. Conditions like valvar regurgitation or stenosis exemplify this: Myxomatous valve degeneration.

Why do dentists ask if you have a heart murmur?

Murmurs may indicate existing heart disease that is a risk factor for infective endocarditis following a dental procedure, as well as more severe heart conditions such as congenital heart disease, atrial fibrillation or congestive heart failure.

What should people with heart murmurs avoid?

Do not smoke. Smoking increases your risk of heart attack and stroke. If you need help quitting, talk to your doctor about stop-smoking programs and medicines. These can increase your chances of quitting for good.

When should I be concerned about a heart murmur?

If you have been told you have a heart murmur and you think you have symptoms of heart valve disease, you should: Talk to your doctor and ask if you should see a cardiologist, especially if you've had shortness of breath, palpitations or chest pain.

Is anesthesia hard on the heart?

Anesthesia and surgery have a wide range of effects on the cardiovascular system. Even in healthy patients having minor operations, anesthetic agents can cause significant cardiac depression and hemodynamic instability.

Why do cardiac conditions pose a risk during dental treatment?

The theory is that bacteria from periodontal infection can enter your bloodstream. Once this occurs, the bacteria accumulate along the blood vessels, causing inflammation, which can make people more vulnerable to heart attacks and stroke.

Can dental procedures cause heart problems?

Now it appears that tooth extraction and other oral surgeries also temporarily — but slightly — increase the risk of a heart attack or stroke.

How does heart disease affect dental treatment?

Patients with angina treated with calcium channel blockers may have gum overgrowth. In some cases, gum surgery may be needed. Like patients with a previous heart attack, patients with angina may want to ask their dentist if oxygen and nitroglycerin are available in case a medical emergency should arise.

How do you manage a heart murmur?

Treatment depends on the heart condition causing the murmur and may include medications or surgery....Valve replacementOpen-heart surgery. This is the main treatment for severe valve stenosis. ... Ross procedure. ... Transcatheter aortic valve replacement (TAVR).

What can make a heart murmur worse?

If you have gone through treatment to replace or repair a heart valve, your murmur may change sound or go away completely. Likewise, murmurs can get worse if a condition goes untreated or becomes more serious. Your heart is unique, and some heart murmurs can change over time.

What do doctors do for a heart murmur?

Surgeries for heart murmurs often include valve repair and valve replacement. These surgeries treat the underlying valve problems in your heart that are causing the murmur. If you do need surgery, your cardiothoracic surgeon will try to make sure your surgery is as minimally invasive as possible.

How to deal with heart murmurs during dental work?

Great oral wellbeing is essential for everybody, in specific anybody a heart murmur needs to give careful consideration to brushing and daily flossing. Keeping a regular checkup with a dental practitioner is advisable.

Why do dentists give anti-infection?

Numerous dental practitioners and oral specialists think that it’s good to give their patients an anti-infection before any teeth operation like a tooth extraction to lessen the danger of infection brought about by bacteria which can affect the heart lining or the heart valve.

Do dental specialists examine heart murmurs?

Not exclusively will your dental specialist examine their involvement with or without the utilization of anti-toxins before dental work procedure, however, they will need to know the information concerning your heart murmur as well as the major cause. This gives a way out to deal with a heart murmur during dental work.

Is it necessary to take anti-microbials before dental work?

However, preventive antibiotics aren’t redundant for anybody. The patients need examination and discussion with the dental specialist before undergoing any dental work.

Do you go to a dental specialist for a heart check?

Nobody goes to the dental specialist to have the heart checked, however for what reason do doctors enquire some information about heart murmurs? According to a highly dental professional team at Sydney, they’re not concerned that you might have a heart attack or heart-related issue while visiting them. Their main concern is the possibility of a heart murmur, which hinders dental operations. Read more about the team at ddssdentistsydneycbd.com.au/about-us/ to get to know them better.

Why do dentists ask about heart murmurs?

No one goes to the dentist to have their heart checked, but why do they ask about heart murmurs? The dentist or oral surgeon is not worried that you will have a heart attack or other heart related issue while visiting them. Dental procedures are no longer the terrifying experience they once were. A heart murmur is a concern before any oral surgery because of infection.

How to treat heart murmurs?

Good oral health is important for everyone, but anyone with an elevated risk factor due to heart murmurs needs to pay close attention to brushing and flossing every day. Keep regular check-ups with your dentist. If oral problems do appear, have them treated immediately to reduce the amount of bacteria in your bloodstream.

What is it called when a heart murmur is caused by a valve?

If the valve is small, forcing the blood into the heart the murmur is called stenosis. If the valve is defective and leaks, it is called regurgitation. Other problems that cause heart murmurs are rheumatic fever, coronary artery disease and infective endocarditis or aging.

What is the infection that can affect people with heart valve problems?

Infective endocarditis (IE) is an infection that can affect people with heart valve problems since the blood does not travel properly through the heart. If the bacteria from an infected tooth is introduced into the body during the surgery, the bloodstream will carry the bacteria to the heart, where it will stick to the heart valve or the lining of the heart. This is called bacterial endocarditis (BE). Bacterial endocarditis can cause very serious problems if it enters the heart including heart failure or more heart valve leakage.

Why do dentists give antibiotics?

Many dentist and oral surgeons find it prudent to give their patients an antibiotic prior to any invasive procedure, like tooth extraction or root canal, to reduce the risk of infection caused by bacteria that can infect the heart valve and lining of the heart.

Why do children have heart murmurs?

In adults, the murmur can be caused by an overworked heart valve or a hole in the wall of the heart. It can also be caused by narrowing blood vessels in the heart. If the valve is small, forcing the blood into the heart the murmur is called stenosis.

Why do dentists need to know your medical history?

Have you ever wondered why a dentist or oral surgeon wants a complete record of your medical history? There is a very good reason they need this information. If you are pregnant, they need to know before they take any x-rays. If you have back injuries, they need to know before they lean you back in the dental chair. If you have a heart murmur, they might give you antibiotics to take before they do any procedures.

What to ask your dentist about dry mouth?

Ask your dentist about dry mouth treatments, including the use of artificial saliva. Points to Remember About Dental Care and Heart Disease. Give your dentist a complete list of the names and dosages of all the drugs you are taking for your heart condition (as well as any other prescription or nonprescription drugs that you may be taking).

What to do if you have a stroke and you have no saliva?

If your strokehas affected your face, tongue, or dominant hand and arm, your dentist may also recommend use of fluoride gels, modified brushing or flossing techniques, adding rinsing and strategies others can use to assist you in maintaining good oral hygiene.

How many teeth do you lose in a stroke?

One study, published in Stroke: Journal of the American Heart Association, found that people who had fewer than 25 teeth at the start of the 12-year trial ( teeth loss is the ultimate end result of untreated gum disease) had a 57% greater risk of stroke compared with patients who had 25 or more teeth.

Does dental anesthesia contain epinephrine?

If your dental procedure requires the use of anesthesia, ask your dentist if the anesthesia contains epinephrine. Epinephrine is a common additive in local anesthesia products. Use of epinephrine in some patients with high blood pressure may result in cardiovascular changes, including the rapid development of dangerously high blood pressure, ...

Can calcium channel blockers cause gum overgrowth?

Patients with angina treated with calciumchannel blockers may have gum overgrowth. In some cases, gum surgery may be needed.

Can you take anticoagulants after a heart attack?

Dental Care After Heart Attack. Talk to your cardiologist about undergoing any dental treatments in case they recommend waiting. And tell your dentist if you are taking anticoagulants ( blood -thinning drugs). These medications could result in excessive bleeding during some oral surgery procedures.

Can high blood pressure cause dry mouth?

Some high blood pressure drugs can cause dry mouth or alter your sense of taste . Calcium channel blockers in particular can cause the gum tissue to swell and overgrow, resulting in chewing difficulties. If you do experience gum overgrowth, your dentist will give you detailed oral hygiene instructions and may ask you to make more frequent dental visits for cleanings. In some cases, gum surgery to remove excess gum tissue, called a gingivectomy, may be needed.

How to protect your heart from a syringe?

Other things to keep in mind to protect your heart health before visiting the dentist include: 1 Learn what your dentist can do in the case of medical emergency, and find out if there is oxygen and nitroglycerin available if needed. 2 Be sure your dentist has your complete medical history, including any relevant bloodwork, and names and contact information for other healthcare providers with whom they may need to consult.

How long should you wait to take antibiotics before dental work?

In general, patients who have suffered a heart attack should wait six months before undergoing any type of dental treatment, and must communicate any medications they are taking, especially any anticoagulants, ...

Why is it important to clean your mouth?

Even routine dental procedures, such as cleaning, can cause bleeding in the mouth, which then allows oral bacteria to enter the bloodstream and possibly travel to the heart. For a patient with a heart condition this bacteria poses the potentially dangerous risk of endocarditis, or inflammation of the heart valves or tissue.

Do dentists know your medical history?

Be sure your dentist has your complete medical history, including any relevant bloodwork, and names and contact information for other healthcare providers with whom they may need to consult. Always be sure to let your dentist know if you have any health concerns before an appointment, and particularly if you might have a heart condition.

Can you have dental surgery if you have angina?

Patients with stable angina (regular chest pain) should consult with their doctors, but those with unstable (irregularly occurring) angina are usually advised not to undergo non-essential dental procedures.

What is an innocent heart murmur?

Tests need to be done to find the cause. A murmur that occurs when the heart is emptying (systolic murmur) generally is an innocent heart murmur. Innocent heart murmurs aren't a sign of heart disease and don't require treatment.

How do you know if you have a heart murmur?

Heart murmurs are usually detected when your doctor listens to your heart using a stethoscope during a physical exam.

Why does my heart murmur go away?

If an innocent murmur is caused by an illness, such as fever or an overactive thyroid (hyperthyroidism), the murmur will go away once that condition is treated. An abnormal heart murmur is closely monitored by your doctor over time.

What test is used to determine if a heart murmur is abnormal?

If your doctor thinks the heart murmur is abnormal, you or your child may need additional tests, including: Echocardiogram. This test is the main test used to determine the cause of a heart murmur. An echocardiogram uses ultrasound waves to create detailed images of your heart's structure and function.

Why do you need antibiotics for heart murmurs?

Doctors used to recommend that most people with abnormal heart murmurs take antibiotics before visiting the dentist or having surgery to prevent bacteria from getting into the lining of the heart (infective endocarditis).

How to treat valve stenosis?

Open-heart surgery. This is the main treatment for severe valve stenosis. Your surgeon removes the narrowed valve and replaces it with a mechanical valve or a tissue valve. Mechanical valves are made from metal. They are durable, but carry the risk of blood clots forming. Tissue valves may come from a pig, cow or human deceased donor. They often eventually need replacement.

What kind of medicine does a doctor prescribe for a heart attack?

Some medications your doctor might give you include: Blood thinners (anticoagulants). This type of medicine prevents blood clots from forming in your heart and causing a stroke.

How to diagnose arrhythmias in dental office?

A specific diagnosis of an arrhythmia during a dental appointment necessitates continuous ECG monitoring and good knowledge of interpretation of the abnormalities observed. Thus, in the usual dental setting, patient history, symptoms, and palpation of the pulse are the available diagnostic tools. The risk of harmful arrhythmias is also increased in patients with cardiomyopathies, heart failure, and valvular problems. Such patients should be carefully evaluated by their physician and adequate medication and other measures (such as an implantable cardioverter-defibrillator) should be implemented before extensive dental procedures. If a patient with known heart disease develops arrhythmia during treatment, the treatment should be discontinued, supplemental oxygen considered, and the patient status closely monitored. If the patient recovers quickly, continuation of treatment may be considered if the patient wishes. Even a brief loss of consciousness, however, may indicate significant cardiac arrhythmia, and the patient should be referred to medical evaluation. If a patient with heart disease collapses in the chair, cardiac arrest should be suspected and emergency medical services activated immediately and cardiopulmonary resuscitation initiated without delay. These patients are advised to take their medication regularly. Beta-blockers are the preferred drug of choice.9

How to control bleeding in dental patients?

Patients on anticoagulant therapy should be delicately handled in a dental setup. This may involve use of local hemostatic measures to control bleeding in anticoagulated patients. These include atraumatic surgical technique, adequate wound closure, pressure application, and topical clotting agents. Oral rinsing with tranexamic acid can also be used. The indication for anticoagulation should be known since many indications allow brief discontinuation of anticoagulant treatment without a substantial increase in the risk of thrombotic events. On the other hand, anticoagulant treatment should in general not be discontinued in patients with mechanical valve prostheses. Close collaboration with the patient's physician is recommended in these matters. In patients receiving long-term anticoagulant therapy and who are stably anticoagulated on warfarin, an international normalized ratio (INR) check 72 h prior to surgery is recommended. This allows sufficient time for dose modification if necessary to ensure a safe INR (2–4) on the day of dental surgery (including subgingival scaling). There is no need to check the INR for non-invasive dental procedures.9

What is cardiovascular disease?

1.  Introduction. Cardiovascular diseases (CVD) comprise of a group of diseases of the heart and vascular system affecting majority of individuals worldwide. Ischemic heart disease, Hypertension, Dysrhythmias, and Infective Endocarditis are some of the cardiovascular conditions most commonly seen among the population.

What is sequential treatment plan for hypertensive patients?

The sequential treatment plan for hypertensive patients generally starts with consulting the physician regarding the current medical status, medication, and patient management during periodontal therapy. Dentist must inform the physician regarding the estimated degree of stress, length of procedures, and complexity of the individualized treatment plan.

Why does dental chair anxiety increase the likelihood of angina attack?

The dental environment increases the likelihood of an angina attack because of fear, anxiety, and pain. A patient who has an angina episode in the dental chair should receive the following emergency dental treatment: Dental procedure is discontinued and Patient is allowed to attain a comfortable position.

How to manage endocarditis?

Management of patients with infective endocarditis will involve Health questioning which will cover history for all potential categories of risk. If any doubt exists, the patient's physician should be consulted. Oral hygiene should be practiced with methods that improve gingival health yet minimize bacteremia. In patients with significant gingival inflammation, oral hygiene is initially limited to gentle procedures. Oral irrigators are generally not recommended because their use may induce bacteremia. Susceptible patients should be encouraged to maintain the highest level of oral hygiene once soft tissue inflammation is controlled.

Why is it important to treat cardiovascular disease?

1) Important goal of treatment to manage patients with cardiovascular diseases is to deal with all the identified risk factors involved. 2) Pre-medication should be considered to alleviate anxiety and effective analgesia is important to reduce stress. 3)

Why do people take antibiotics before dental surgery?

The antibiotics were to kill any oral bacteria entering the bloodstream and prevent the formation of infected clots on the heart valves.

Is endocarditis fatal?

Endocarditis is rare, but is difficult to treat and potentially fatal. But there are growing concerns regarding antibiotic safety for patients, and the issue of increasing antibiotic resistance.

Can mouth bacteria cause heart problems?

Your mouth is home to a large number of different bacteria, which normally don’t cause harm. But sometimes, for example if they get into the bloodstream, the bacteria can become harmful. Oral bacteria known as streptococci can cause unwanted clots on heart valves, leading to a heart condition known as infective endocarditis – an infection of the inner lining of the heart. It’s rare, but is difficult to treat and potentially fatal.

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