Key result
Safe dental care in cardiovascular patients requires INR monitoring, antibiotic prophylaxis, and capping epinephrine at ~0.04 mg.
Why the study?
Patients with cardiovascular disease are frequently encountered in routine dental practice and require special care regarding medication drug interactions, local anesthetic selection, and anticoagulant management, motivating this analysis of major dental treatment approaches.
Systematic Review
Safe dental management of patients with cardiovascular disease requires detailed preoperative anamnesis, multidisciplinary coordination between dentists and physicians, vital sign monitoring, appropriate local anesthetic and vasoconstrictor dosing, hemostatic preparedness, and targeted antibiotic prophylaxis for high-risk individuals.
Detailed preoperative assessment and vital sign monitoring are essential for CVD patients in dental settings; extends evidence supporting medical-dental coordination protocols.
Introduction: Cardiovascular diseases can have a congenital origin, that is, present from birth, such as interatrial and interventricular communication, defects of the artery, coronary arteries, or acquired coronary artery anomalies that involve several risk factors such as smoking, alcohol, old age, and a sedentary lifestyle. Thus, acquired ones are the most frequent in the routine of a dental practice, so the dentist should be able to attend to those patients who need special care, regarding the correct use of medications due to the risk of drug interactions, the type of local anesthetic to be used, and the management of patients who use anticoagulant therapy. Objective: It was to analyze the major approaches to dental treatment in patients with cardiovascular disease. Methods: A search was made in the databases Scopus, Embase, Scielo, PubMed, and Academic Google in the period 2003 to 2026, following the rules of systematic review-PRISMA. Results: A total of 36 papers that were submitted to the eligibility analysis were collated and, after that, 18 studies were selected. Most studies presented homogeneity in their results, with Chi-Square (X2)=79.7%>50%. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 07 studies with a high risk of bias and 04 studies that did not meet GRADE and AMSTAR-2. In all cases of patients with cardiovascular diseases, the preoperative anamnesis should be done with all the details, always observing the risk factors, that progress to include the medications used; if the patient makes use of cardiac prostheses, monitor the vital signs before and after dental procedures, always recording all occurrences and procedures in medical records. Conclusion: It is necessary for the dental treatment of these patients with heart disease to have good knowledge of the subject and requires medical and dental coordination. Dental surgeons need to be prepared to identify possible medical and dental emergencies and take steps to prevent or treat them effectively and quickly.
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Furlan et al. (2026) conducted a systematic review in Cardiovascular disease in patients undergoing dental treatment. Dental treatment approaches (preoperative anamnesis, antibiotic prophylaxis, local anesthetics, and hemostatic measures) was evaluated on Major approaches and safety protocols for dental treatment in patients with cardiovascular disease. Dental management of cardiovascular patients across 18 studies (Chi-Square=79.7%) requires vital sign monitoring, INR testing, antibiotic prophylaxis, and limiting adrenaline to 0.04 mg.
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