Patients with heart disease are afraid of dental interventions, for fear of complications that may arise. However, doctors say that they can be performed, under clearly established conditions, including dental implants in patients with major cardiac events in the antecedents.
For a complex intervention such as a dental implant, it is necessary for the patient’s health to be in balance. If this condition is met, including people with severe cardiac events in the antecedents, they can benefit from such services, explained doctor Corrado Cazacu, dental-alveolar surgery specialist, in the show “Youth without old age” produced by Izabela Pănescu on Digi 24.
Before a complex intervention, the patient first benefits from a consultation during which information about the state of health is analyzed and a treatment plan is decided. A medical letter from the cardiologist is also necessary, explained Dr. Cazacu.
“If he is known to have high blood pressure or maybe a history of heart attack or various cardiovascular problems, it is important that he comes prepared and also says what medication he is taking, because the medication can be diverse depending on the pathology the patient has. But as long as the patient is balanced, takes the medication and the blood pressure is in balance, and in general the other cardiovascular pathologies are compensated, then the patient is considered as a normal patient and can put that dental implant as well”, the doctor pointed out.
How long after stroke or heart attack is the implant possible?
If he has suffered a stroke or a heart attack, the patient can benefit from a dental implant, but at a certain period after the vascular event.
“In this situation it is very important to understand that the dental implant cannot be placed or the patient cannot have surgery in the first six months after this event, either a heart attack or a stroke. But, once this period passes and the body recovers, the patient can receive that dental implant”, explained doctor Corrado Cazacu. Intervention is not possible in less than half a year because the heart muscle or nerve tissue, as the case may be, needs recovery to regenerate, otherwise there is a risk of a new stroke/infarction. “After six months, the risk of this incident happening again drops drastically.” the doctor also said.
Many patients who had such problems in the past, the doctor noted, could benefit from one to 12 dental implants and complex oral rehabilitation. It is important, especially for these patients, to be monitored during the intervention with a dental implant, that is, to be part of the team of specialists that intervenes with an anesthesiologist to monitor the patient’s blood pressure and well-being. “That is, if he immediately sees on the vital functions monitor that the patient is under stress, to adjust the dose of that drug with which the sedation is done, so that the patient returns to optimal parameters again”the doctor explained.
For patients on anticoagulant treatment, the therapeutic conduct requires compliance with the classic protocol, i.e. the treatment is interrupted with the consent of the attending physician (cardiologist or neurologist). Usually the attending physician prescribes another type of medicine, another type of short-acting anticoagulant, which will allow two days after the discontinuation of the basic anticoagulant to carry out the surgical intervention, with a minor risk of bleeding. Afterwards, the patient’s classic medication is resumed, after a day or two, depending on what the attending physician recommends, said doctor Corado Cazacu.
Another concern of patients with high cholesterol values, this time, is that there would also be risks in their case. The doctor explained that the simple fact that there are high cholesterol values does not constitute a contraindication for the intervention, but things must be analyzed in a wider context, because a patient with high cholesterol generally has other associated diseases, usually cardiovascular diseases.
Treatment for the underlying disease is not interrupted
For hypertensive patients, the doctor’s advice is not to interrupt the treatment when performing the dental implant intervention or even a trivial tooth extraction. What the doctor also noticed in the office, however, is that some patients follow the treatment initiated even 2-3 years before, without a cardiology re-evaluation having been carried out in the meantime. In their case there is a risk of blood pressure values that exceed the accepted limits and for this reason a recent visit to the cardiologist is necessary.
Another fear of patients, emphasized the producer Izabela Pănescu, is that of anesthesia, even more so if there are medical problems in the antecedents.
The risk of an increase in blood pressure (the blood pressure can also increase due to fear) can be managed by the team of specialists, the doctor explained, and among the solutions adopted in this case is the technique of conscious sedation, which offers the benefit of patient relaxation.
On the other hand, a dental implant cannot be performed in case of serious problems that require surgery at the level of the blood vessel or at the level of the heart. The doctor explained that these problems need to be solved first, after which the possibility of making the implant is evaluated.
