Pre-Cardiac Dental Treatment Does Not Increase the Risk of Adverse Events.

PURPOSE: Elimination of dental sources of infection prior to cardiovascular surgery (CVS) is performed to reduce perioperative infection and complications. This study aims to evaluate if preoperative dental intervention is associated with increased risk of adverse events. METHODS: A retrospective medical record review of inpatient consultations (n = 1513) completed by the Hospital Dentistry Service at University of California Los Angeles Medical Center from January 2011 to December 2020 was performed. Seven hundred thirty-eight consults met the inclusion criteria and were divided into 4 groups: Group A were patients that were dentally unhealthy and received surgical dental intervention (n = 265), Group B were patients that were dentally unhealthy and underwent non-surgical dental treatment (n = 14), Group C were patients that were dentally unhealthy and did not receive the recommended dental treatment (n = 29), and Group D were patients that were dentally healthy requiring no intervention (n = 430). They were evaluated for major adverse events in 3 categories: dental complications, medical adverse events and death. RESULTS: Dental complications were only experienced in Group A, all of which were bleeding. Only 2 patients were found to have major bleeding, which was more likely due to anticoagulation and CVS rather than dental extractions. There was no significant difference in the number of medical adverse events or number of deaths during the postoperative period between groups. CONCLUSIONS: The results of this study suggest that elimination of oral infection prior to CVS does not increase the risk of morbidity or mortality.

A retrospective chart review evaluating pre-operative dental extractions on patients with end-stage heart failure undergoing advanced surgical cardiac therapies.

OBJECTIVES: End-stage heart failure patients are functionally compromised by multiple physiologic mechanisms, placing them at increased risk of peri- and post-operative complications. This study aimed to evaluate if dental treatment performed before advanced cardiac interventions, including orthotopic heart transplant and mechanical circulatory support, increases the risk of adverse events. STUDY DESIGN: A retrospective chart review spanning January 2011 to December 2020 was performed. Inpatients with end-stage heart disease were evaluated by the hospital dentistry service at UCLA Ronald Reagan Medical Center. Three hundred and five consults met the inclusion criteria. The patients were divided into 2 groups: those who underwent dental treatment and those who did not require dental treatment. The wait time from dental consultation to cardiac intervention (days), dental complications, medical adverse events, and deaths were evaluated. RESULTS: Dental complications were only experienced in the form of intraoral bleeding. There was no significant difference in the number of medical adverse events or deaths between groups. CONCLUSIONS: The elimination of oral infection before advanced cardiac interventions does not increase the risk of morbidity or mortality.