A Review of Dental Imaging and Treatment Protocol Prior to Open Heart Valve Surgery: An Evidence-Based Approach

Context: Open heart valve surgery is associated with a significant risk of infective endocarditis (IE), often linked to oral infections. Despite existing guidelines recommending dental evaluations before surgery, there is no standardized protocol for dental imaging and treatment in this high-risk population. This study aims to present the first evidence-based protocol for dental imaging and treatment to systematically identify and address oral infections, thereby reducing perioperative risks and improving outcomes. Evidence Acquisition: A comprehensive review of current literature on the relationship between oral infections and infective endocarditis was conducted. Existing guidelines from the American Heart Association (AHA) and European Society of Cardiology (ESC) were analyzed. Imaging modalities were integrated into the proposed protocol for preoperative dental evaluation. A risk-based classification system for common dental conditions and antibiotic prophylaxis was developed. Results: The protocol utilizes Imaging techniques to detect oral infections and conditions that could lead to bacteremia, such as dental caries, periodontal disease, and impacted teeth. It also introduces a risk-based approach for managing dental conditions, prioritizing treatments based on urgency, and recommending appropriate antibiotic prophylaxis. This interdisciplinary approach enhances collaboration between dental and cardiac care teams. Conclusions: This study introduces a novel dental imaging and treatment protocol for patients undergoing open heart valve surgery, significantly reducing the risk of infective endocarditis. By addressing oral health systematically before surgery, this protocol improves surgical outcomes and sets a new standard of care for cardiac patients. Future research should validate its effectiveness across diverse healthcare settings and evaluate its long-term impact on patient outcomes.