title: Oral health, dental treatment, and cardiac valve surgery outcomes.
abstract: The aim of this study was to determine whether not treating chronic dental infection during the admission for cardiac valve surgery would increase the morbidity and mortality of patients. Patients were divided into three groups: dentally unhealthy and untreated (Group A), dentally healthy not requiring treatment (Group B), and dentally unhealthy and treated (Group C). Hospital computer records and phone interviews were used to assess morbidity and mortality as assessed through the Social Security Death Index. Ninety-eight patient charts were reviewed. Patients in Group A (n = 47)were not at a significantly greater risk for developing infective endocarditis (IE) within 6 months of cardiac surgery compared to patients in Groups B (n = 17) and C (n = 34). Also, patients in Group A did not have a significantly higher rate of mortality compared to other groups (p= .09). The results suggest that there is no need to treat chronic oral infections in patients with compromised cardiac function within 24 to 48 hours prior to cardiac valve replacement surgery since this will not lower the risk of IE and death following cardiac valve surgery. Multicenter prospective case-controlled studies are needed to address this question definitively.
authors.affiliation: Division of Dentistry and Oral Medicine, Brigham and Women's Hospital, Boston, MA, USA.
authors.forename: Grace Hsiao
authors.initials: GH
authors.lastname: Wu
authors.forename: Steve
authors.initials: S
authors.lastname: Manzon
authors.forename: Rachel
authors.initials: R
authors.lastname: Badovinac
authors.forename: Sook-Bin
authors.initials: SB
authors.lastname: Woo
mesh_terms: D000368:Aged; D002180:Candidiasis, Oral / Q000150:complications; D003731:Dental Caries / Q000150:complications*; D004697:Endocarditis, Bacterial / Q000209:etiology*; D005260:Female; D006349:Heart Valve Diseases / Q000601:surgery; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation; D006351:Heart Valves / Q000601:surgery*; D006560:Herpes Labialis; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D010483:Periapical Diseases / Q000150:complications; D010510:Periodontal Diseases / Q000150:complications*; D011184:Postoperative Period; D012189:Retrospective Studies; D013283:Stomatitis, Herpetic; D014095:Tooth, Impacted / Q000150:complications; D016896:Treatment Outcome