Cardiovascular disease

WHAT IS THE LINK BETWEEN ORAL/DENTAL DISEASE AND CARDIOVASCULAR DISEASES?

The health of your gums influences the state of your arteries.

ecent studies have shown a close link between the presence of bacteria in the oral cavity responsible for the periodentites, (loosening of teeth) and the thickening of the arteries, (atherosclerosis) linked to a risk of cardiac insufficiency, MI (Myocardial infarct), CVA, (Cardio vascular accident), renal insufficiency… It is therefore strongly recommended to maintain a clean mouth & if previously declared paradental illness is present, treatment should be started.

Looking after your mouth is looking after your cardiovascular system!

THE RISK OF INFECTED ENDOCARDITIS

Les maladies cardio-vasculaires

Infective endocarditis is an infection affecting the heart valves that can be fatal. It is due to bacteria entering the body by a lesion circulating through the vascular system and grafting into the heart.

The oral infections, be they from a carie or paradental, (bleeding from the gums or loosening of teeth) are the way in which the bacteria can enter your general circulation. Oral dental illness is the first cause of infected endocarditis, (30% of endocarditis is due to oral germs.)

You carry a risk of developing infected endocarditis if you have a valve prosthesis and if you have had a previous episode of endocarditis or if you suffer from congenital cardiomyopathy with a residual shunt.  It is very important to have a rigorous oral hygiene regime to reduce the risk of infection.

In addition, the HAS (High Authority of Heath) has established recommendations for the oral treatments it is possible to carry out with no risks if you have a high risk of getting Endocarditis. Some actions are forbidden, like root treatments of teeth with multiple roots, (molars, pre molars) or necrotic teeth (where the nerve is already dead). Meaning that if you leave an untreated decay that finally meets the nerve of the tooth, this will not be able to be treated and it will have to be removed. It is therefore truly recommended to avoid the development of tooth decay and treat early lesions quickly.

WHAT TO DO TO PREVENT?

Having a balanced diet, avoiding a lot of sugar is very important, and avoiding grazing will reduce the risk of decay. A good brushing routine at least twice a day & ideally after each meal will reduce the risk of decay and the risk of paradental disease. It is these basic measures, unavoidably that should be followed daily to maintain good oral health and avoid complications.

It is important to undertake an oral-dental assessment, and if any pathologies are discovered treating them in order to restore balance in your mouth.
After this, a appointment to review and a prophylactic clean is necessary once to twice a year or more often if required (for example if paradental disease is not stabilised).

WHAT PRECAUTIONS AT THE DENTIST?

  1. Firstly, inform your dental surgeon of your pathology, inform him of your drug list and your cardiologists contact details.
  2. Depending on your pathology and the type of dental work to be undertaken, antibiotic treatment may be required. Your dentist will evaluate in discussion with your cardiologist.
  3. To not stop your anticoagulation therapy without discussing with your physician.
  4. The haemorrhagic risk of dental work is much less than the thromboembolic risk of interrupting your anticoagulation therapy. In addition your dentist will take the required measures to provide a good haemostasis (stop bleeding) after your treatment.
  5. It is important to limit the stress that can be caused by your dental appointment. Therefore do not hesitate to speak about your fears, it is important that you have faith and feel comfortable during your dental treatment. A good relationship with your treating team is important so that you feel confident and comfortable during your dental treatment. Techniques exist such as alert sedation or hypnosis that can help you. It is also recommended that you do not come to your appointment without eating or extremely tired.