Dental Management of the Cardiovascular Compromised Patient: A Clinical Approach

Cardiovascular disease trends, complications, and associated therapeutics, impact the dental health and treatment. Such patients require special consideration with regard to when and which dental treatment is appropriate and what precautions are required. A clinical approach is provided for the dental management of patients with Arterial hypertension, Heart failure, and Ischemic Heart disease, Cardiac Arrhythmias, Infective Endocarditis, Stroke and Cardiac Pacemaker. A Medline-PubMed search was conducted of the literature over the last 20 years using the keywords: “cardiovascular diseases”, “dental management”, “arterial hypertension”, “heart failure”, “ischemic heart disease”, “cardiac arrhythmias”, “infective endocarditis”, “stroke” and “cardiac pacemaker”. A total of 46 articles were reviewed, of which 32 were literature reviews, 3 were expert committee guides and updates and 11 original research papers. The appropriate management of dental patients with cardiovascular disease is contingent on appropriate assessment and evaluation. This article aims to allay many of these uncertainties by describing the commoner cardiac conditions, the risk they pose during dental practice and how they may affect dental treatment. It outlines prophylactic and remediable measures that may be taken to enable safe delivery of dental care. Key words: Cardiovascular disease, Dental management, Arterial hypertension, Heart failure, Ischemic heart disease, Cardiac arrhythmias, Infective endocarditis, Stroke and Cardiac pacemaker.