title: Treatment of oral infections prior to heart valve surgery does not improve long-term survival.
abstract: The objective was to evaluate the importance of preoperative elimination of oral infections and oral health for survival after heart valve surgery In a group of patients (n=149; treatment group, GP group), oral health was examined and dental treatment was performed 3-6 months prior to heart valve surgery. In a second group (n=103; control group, SP group), oral health was examined postoperatively, but patients did not receive dental treatment prior to surgery. Sixteen years after heart valve surgery was performed, morbidity endpoint data were obtained. Differences in survival between the two groups and the influence of differences in oral health were analyzed. Fewer patients survived in the study group (37%) compared with the control group (45%). Mean survival was 122.9 months in the GP group compared with 143.3 months in the SP group, including time to death and those alive at the endpoint (p=0.018). A positive relationship was found between the number of teeth and survival, with RR = 0.98 (95% CI 0962-0.996 (p=0.016)).The deaths from heart valve disease were 18% in the GP group and 7% in the SP group (chi2=3.65, df=1, p=0.56). At the long-term follow-up,the results of the present study show,that it was not possible to demonstrate that dental treatment before heart valve surgery improved survival. Therefore, the need for extensive dental treatment prior to heart valve surgery may be reconsidered.
authors.affiliation: Mun-H-Center, Odontologen, National Orofacial Resource Center for Rare Disorders, Gothenburg, Sweden. john.bratel@vgregion.se
authors.forename: John
authors.initials: J
authors.lastname: Bratel
authors.forename: Charles
authors.initials: C
authors.lastname: Kennergren
authors.forename: Leif
authors.initials: L
authors.lastname: Dernevik
authors.forename: Magnus
authors.initials: M
authors.lastname: Hakeberg
mesh_terms: D000368:Aged; D003773:Dental Plaque / Q000150:complications / Q000628:therapy; D004697:Endocarditis, Bacterial / Q000517:prevention & control; D005260:Female; D005500:Follow-Up Studies; D005891:Gingivitis / Q000150:complications / Q000628:therapy*; D006349:Heart Valve Diseases / Q000401:mortality / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009909:Oral Health; D010518:Periodontitis / Q000150:complications / Q000628:therapy*; D011300:Preoperative Care; D011446:Prospective Studies; D018805:Sepsis / Q000517:prevention & control; D013280:Stomatitis / Q000150:complications / Q000628:therapy*; D016019:Survival Analysis