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Many heart problems requiring special care at the mouth and teeth. If someone has already suffered a heart attack, hypertension, angina pectoris, cerebrovascular accident (stroke) or heart failure, the condition should be discussed with your dentist or with the physician before any dental procedure. A person with heart disease should maintain the health of his mouth by practicing good oral hygiene and visiting your dentist regularly. It is also important to follow the instructions of the physician or dentist when they prescribe specific drugs such as antibiotics.

Infective endocarditis Infective endocarditis is a relatively rare infection that reaches the heart valves, but can be fatal. Infection occurs when bacteria or other micro-organisms enter the body and come to the heart. The mouth is a common gateway for bacteria. To prevent infective endocarditis in patients with weakened the heart, it is advisable to take antibiotics prior to certain dental treatments. The American Heart Association (American Heart Association) recommends taking antibiotics before dental treatment for patients with:

• History of infective endocarditis;
• One or more artificial valves;
• A heart transplant or heart valve disease (malfunction of the valves);
• Certain congenital heart defects.

In addition, the American Heart Association advises to take antibiotics before dental treatment include:

• Tooth extraction;
• Root canals;
• Placement of implants;
• The cleaning of teeth or an implant, if bleeding is anticipated;
• Injections of local anesthetic intraligamentary;
• The relocation of natural teeth after tooth extraction (tooth fell in one piece after an accident);
• The procedures for periodontal (gum examinations, curettage and surgery of the gums);
• The introduction of orthodontic bands but not for cases;
• Placement matrix of antibiotics under the gumline.

Hypertension There are some medications used to treat high blood pressure that would cause xerostomia (dry mouth) and dysgeusia (altered sense of taste). Other drugs may lead to fainting when the patient moves from the position lying on the dentist’s chair to a standing or sitting.

Some medicines against hypertension, such as calcium channel blockers can cause gingival hyperplasia (excessive growth of the gums). Gingival hyperplasia can start from one month after someone starts taking the drug. The gum of certain people can become so thick that has difficulty chewing and surgery is thus needed to make the correction. If the dentist’s comment gingival hyperplasia, the patient must follow the specific instructions of hygiene and have more frequent dental cleanings. Before a patient with hypertension receives dental treatment, the dentist may request to take a blood pressure reading. Local anesthetics can be received safely even if they contain epinephrine (adrenaline). Furthermore, most people with hypertension can safely take a medicine against anxiety, such as nitrous oxide or diazepam (Valium). Heart attack Symptoms of myocardial infarction (heart attack) describe themselves as pain that begins in the chest and radiates to the jaw. Someone who had a heart attack should wait at least six months before having dental treatment. It is important to provide the dentist a detailed list of medications taken to prevent complications. For example, if a patient is taking blood thinners, blood clots form more slowly and treatments such as tooth extraction might require a temporary modification of doses of the drug. Angina pectoris Just as a heart attack, angina pectoris may be felt as pain that starts at the chest and radiates to the jaw. Some medications such as calcium channel blockers may cause gingival hyperplasia (gum overgrowth), which may begin one month after the start of the medication. The gum of certain people can become so thick that has difficulty chewing and surgery is thus needed to make the correction. If your dentist detects this problem, the patient must follow the specific instructions of hygiene and have more frequent dental cleanings. Patients with stable angina can be treated like all other patients receiving any dental treatment. However, people who suffer from unstable angina should not undergo elective dental procedures and focus solely on emergency treatment It is recommended to reduce stress during a visit to the dentist because stress can trigger attacks of angina pectoris. It is also important to bring its drugs to the dental clinic. To reduce stress, it is recommended to sleep the night before seeing the dentist and avoid caffeine before the appointment. Heart failure Several drugs prescribed for patients with heart failure may cause xerostomia (dry mouth) and dysgeusia (altered taste). For these patients, there are usually no special concerns when receiving dental treatment, though of course there are no complications or side effects. People who suffer from severe heart failure should consider dental treatment performed in a hospital clinic. They should not be left lying in the dental chair for too long because the accumulation of fluid in the lungs can affect breathing. It is also recommended to go slowly when moving from a lying position on the chair to standing or sitting, because dizziness can occur easily. CABG Bypass surgery is a surgical procedure, which involves bypassing a narrowing or complete blockage of a coronary artery by grafting an artery or vein taken from another body part. If a patient who underwent bypass surgery had to have dental treatment, he or she may experience severe pain while lying in the dental chair. This is a side effect of surgery. Taking antibiotics before dental treatment is not usually necessary unless the surgery was done several weeks before seeing the dentist. Pacemaker A pacemaker or pacemaker is a medical device that uses electrical pulses to stabilize the heartbeat. The main purpose of a pacemaker is to maintain an adequate cardiac rhythm, either because the current of the heart rhythm is not fast enough, or because there is a block in the electrical conduction system of the heart. It is very important to inform the dentist if you have a pacemaker because all electromagnetic dental appliances should be avoided. In addition, elective dental treatment should be deferred for several weeks after surgery. If an emergency dental procedure should be performed, the dentist or doctor may prescribe antibiotics before treatment.