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What is your standard procedure for patients who recently had a cardiovascular event

Ask the Expert ForumCategory: Periodontal TherapyWhat is your standard procedure for patients who recently had a cardiovascular event
Avatarguestuser Staff asked 5 years ago

I have been a RDH for 5 years and have worked the majority of that time at the same office but have recently moved to a new office. I was trained in school there was a standard waiting period for patients who had suffered a cardiovascular event – at my old office we waited 6 months to resume any non-emergency treatment. Today at my new office I saw a periodontal patient who upon reviewing her health history stated she had a stroke 1 month ago, I discussed with the DDS and she said there was no reason to postpone treatment so I called her treating physician who stated she had never heard of any contraindication for postponing dental treatment. My question is what is your standard procedure for patients who recently had a cardiovascular event?

1 Answers
Jill Rethman, RDH, BAJill Rethman, RDH, BA Staff answered 11 months ago

There is no set guideline for when a patient who has had a cerebrovascular accident (stroke) should be seen for periodontal maintenance. In some ways, it could be argued that maintenance as soon as possible is a good idea to resolve any active oral infection that might be present. Treating that infection might prevent another cardiovascular event from occurring. It’s been theorized that even minor infection could alter blood coagulation and lead to possible thrombosis. an additional consideration is that the stroke patient is likely taking anti-coagulant medication. Therefore, the oral healthcare professional needs to be acutely aware of this especially when performing procedures that induce bleeding (such as scaling & root planing. I found an excellent article that may help answer some of your questions: “Oral Care for Patients with Cardiovascular Disease and Stroke.” http://www.jada.info/content/133/suppl_1/37S.full?related-urls=yes&legid=jada;133/suppl_1/37S It provides specific guidelines for treating patients who have these conditions. What’s important to remember is that each patient is different and you need to assess the degree of after-effects and the patient’s current stability. It’s also key to stress the importance of meticulous oral hygiene to keep infection under control. So maybe it’s best to see a stroke patient as soon as he or she is able to visit the office.