[Cardiological (pharmaco)therapy and dental practice]

Area of Science:

• Cardiology
• Dental Medicine
• Interventional Cardiology

Background:

• Advances in treating acute coronary syndromes, heart failure, and arrhythmias are common.
• Polypharmacy, including dual antiplatelet therapy (aspirin and clopidogrel), is prevalent post-percutaneous coronary intervention.
• Patients with cardiac conditions increasingly receive implantable cardioverter defibrillators (ICDs) for heart failure and rhythm disturbances.

Purpose of the Study:

• To review the safety and management of dental procedures for patients with cardiovascular conditions.
• To provide guidance on managing antiplatelet and anticoagulant therapy around invasive dental treatments.
• To address the safety of implantable cardioverter defibrillators (ICDs) in a dental setting.

Main Methods:

• Literature review of recent advancements in cardiovascular disease management.
• Analysis of guidelines and clinical considerations for dental interventions in cardiac patients.
• Discussion of risks and benefits associated with medication adjustments and device safety.

Main Results:

• Temporarily pausing aspirin in coronary artery disease patients may be safe and reduce bleeding risk during dental procedures.
• Implantable cardioverter defibrillators (ICDs) pose no significant risk in dental offices, even if discharged.
• Endocarditis prophylaxis is recommended for patients with prosthetic heart valves before invasive dental treatment.

Conclusions:

• Dental practitioners should collaborate with cardiology and thrombosis services for optimal patient management.
• Careful consideration of medication (antiplatelets, anticoagulants) and device status is crucial for safe dental care.
• Hospital admission may be necessary for urgent or extensive dental procedures in high-risk cardiac patients.