There has been a known link between heart heath and dental health for around a century. The health of your mouth can affect the health of your heart, but equally the health of your heart can affect your dental treatment. Read on to find out what your dentist needs to know about your heart health and how you can help your heart by visiting your dentist regularly.
Blood Thinning Medications
It is important to tell your dentist if you are taking any medications that thin your blood. You may be on these to prevent blood clots, which can be caused by narrowing arteries, atrial fibrillation, or a prosthetic heart valve. The dentist needs to know which medication you are taking, the dosage and why you are taking it.
Some complementary medicines, including fish oil, ginkgo biloba and glucosamine have a weak blood thinning effect.
Blood thinning medications become important if any surgery is planned e.g removal of a tooth, implants or surgery to the gums. Your dentist may liaise with your GP, or whoever prescribed the medication. Your dentist/doctor will weigh up the risks of not taking your medication versus the risk of bleeding. Do not stop taking your medication of your own accord. Only in certain circumstances will your GP advise stopping a medication.
Many medications can have implications
for your dental care.
High blood pressure
If you have hypertension (high blood pressure) which is controlled and stable, dental treatment will not be a problem. However, your blood pressure may be increased by severe longstanding dental pain, dental phobia and anxiety. Make sure you and your dentist implement a preventive programme and get any aches or pains seen to straight away. Speak to your doctor or dentist about management of your anxiety.
If you are taking blood pressure medication, good oral health can actually help your medication be more successful, as shown in this study in 2018.
Some medications for high blood pressure can cause dry mouth or alter your sense of taste. Your dentist will be concerned about dry mouth as this can increase your risk of dental decay and gum disease. Your dentist will be able to suggest products to help with your dry mouth symptoms. They may also want to rule out other causes of dry mouth.
Some medications, namely calcium channel blockers eg. amlodipine (Nordip), felodipine (Felodil XR), lercanidipine (Zanidip), nifedipine (e.g. Adalat Oros) can cause overgrowth of the gums. Your dentist will want to talk to you about your oral hygiene and make sure your brushing and flossing techniques lead to healthy gums.
After a heart attack or heart surgery
If you have had a heart attack, stent placement or coronary artery bypass surgery, elective dental treatment should be deferred for 3 months. However, don’t put off getting any emergency dental work completed. As mentioned before, dental pain can cause an increase in blood pressure.
Don’t put off getting any pain checked out.
Angina
If you tend to have angina attacks, bring your medication (tablets or spray) to your dental appointment. Stable angina isn’t a contraindication to having dental treatment. If your angina is unstable, your dentist may want to speak to your doctor.
Infective Endocarditis
Endocarditis is an infection of the inner lining of the heart and heart valves (the endocardium). Infective endocarditis occurs when bacteria settle on damaged heart lining/valves causing infection. These bacteria can travel from distant sites, E.g the mouth through the blood to the damaged heart tissue.
Your cardiologist may advise that you take antibiotics before any invasive dental treatment (eg. extractions, deep cleanings, other surgery such as implants). This is called antibiotic prophylaxis. An antibiotic is given before a dental procedure to limit the risk of bacterial infection. It is only given when the risk of infection is high. This is usually in patients with prosthetic heart valves, those who have had infective endocarditis before, or those with certain cardiac defects. Your cardiologist and dentist will assess your risk of infection versus the risk of antibiotics (allergy, resistance etc).
We are all at risk all of the time of bacteria entering our bloodstream (bacteraemia) from our mouths. This is one of the ways in which our general health and oral health is linked. Every time we eat, brush, floss etc, we can be displacing bacteria into our blood. For this reason it is so important to ensure good oral hygiene, so we are reducing not only the amount of bacteria in our mouths, but also the amount of inflammation. Inflamed gums are more likely to bleed and are a bigger risk factor for bacteraemia. This is also why it is important to see the dentist regularly, so they can pick up on any early signs of gum disease. Those with heart issues involving the endocardium should be seeing their dentist at least twice per year.
Always give your dentist your full medical
history.
Heart Failure
It is important to tell your dentist if you are suffering from heart failure. You may sleep at night propped up on pillows, therefore tell your dentist this so they don’t lie you flat in the dental chair.
Heart Arrhythmia
If you suffer from a heart arrhythmia, Eg. Atrial fibrillation, be sure to let your dentist know. In addition, tell them which medications you are taking. This may affect how the dentist delivers your treatment, including which anaesthetic they use.
Final Points
- See your dentist regularly to keep your mouth and heart in good shape. Always update them of any changes in your medical history/medications at each visit.
- Make sure you give your dentist a complete list of the names and doses of all medications you are taking (including complementary medications). This will help the dentist decide on the best treatment for you, including which medications/anaesthetics are safe for you.
- Let your dentist know the names and contact numbers of your doctor and any specialists e.g cardiologist you are seeing. Your dentist may want to liaise with them about your care.
- If you are feeling nervous or suffering with anxiety regarding your dental care and heart condition, please speak with your dentist and/or doctor/cardiologist. They can help with strategies/possible medications to help. Don’t let a fear put you off seeking treatment as this will be more detrimental to your health.
