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Dental care for people with heart disease

Special attention to oral health may be recommended for people with heart disease and heart conditions.

Here are some tips to consider before going to the dentist with some heart conditions:

Dental care after a heart attack

Wait a minimum of six months after a heart attack before undergoing any dental treatments. Tell your dentist if you are taking anticoagulants (blood-thinning drugs). These medications could result in excessive bleeding during some oral surgery procedures. Ask your dentist about managing a heart emergency during an appointment.

High blood pressure (hypertension)

Some high blood pressure drugs can cause a 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 cleaning. In some cases, gum surgery may be required. A gingivectomy is the name of the surgical procedure performed to remove excess gum tissue.

If your dental procedure requires the use of a local anaesthetic, ask your dentist if the anaesthetic contains adrenaline. Adrenaline is a common additive in local anaesthetic products. Use of adrenaline in some patients with high blood pressure may result in cardiovascular changes - including the rapid development of dangerously high blood pressure, angina, heart attack, and arrhythmias - and therefore should be used with caution.

Heart-related chest pain (angina)

Patients with angina treated with calcium channel blockers may experience gum overgrowth. In some cases, gum surgery may be required.

While patients with stable angina (chest pain that occurs in a predictable pattern) can undergo any dental procedure, patients with unstable angina (new chest pain, angina that is not fully controlled or is unpredictable) should not undergo elective (non-essential) dental procedures, and emergency dental care should be performed in a hospital or premises equipped with cardiac monitoring capability.

Stroke

If you’ve had a stroke in the past, tell your dentist if you are taking anticoagulants (blood-thinning drugs). These medications could result in excessive bleeding during some oral surgery procedures.

If your stroke has impaired your ability to produce an adequate amount of saliva, your dentist may recommend the use of artificial saliva. If your stroke has affected your face, tongue, or dominant hand and arm, your dentist may also recommend the use of fluoride gels, modified brushing or flossing techniques, and strategies others can use to assist you in maintaining good oral hygiene.

Oral health and heart failure

Some medications used to treat heart failure (such as diuretics, or “water pills”) can also cause dry mouth. Ask your dentist about dry mouth treatments, including the use of artificial saliva.

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