DEAR MAYO CLINIC: I’ll be having a heart procedure in the next month or two, and I was told to see my dentist beforehand. Why is this necessary?
ANSWER: A dental exam before surgery helps to rule out dental abscesses, dental infection or gum (periodontal) disease. This is important because dental infections may lead to bacteria entering the bloodstream that could settle into surgical areas and cause complications. Clearance from your dentist may be needed or recommended before a wide variety of surgeries, but it’s especially important with heart procedures, such as a valve replacement; joint replacements; and organ or stem cell transplants.
A recent study showed how dental work may reduce complications of major cancer surgery. After analyzing data on people who underwent surgery for cancers of the head, neck, esophagus, stomach, lung, liver, or colon and rectum, researchers discovered that people who saw their dentist beforehand were less likely to develop pneumonia after surgery or die within the first 30 days of surgery.
Ideally, any dental work should be done as soon as possible Mayo Clinic experts require that dental work be done at least four weeks before hip or knee replacement surgery. Dental complications occurring too close to a planned elective surgery may result in the surgery being delayed.
Dental work paired with anesthesia may pose risks, particularly for those with poor heart health. Mayo Clinic research has shown that a small but significant percentage of people who had tooth extraction before heart surgery developed major complications, including stroke, kidney failure and death. Talk to your dentist and surgeon about how the need for any dental work weighs against the risks for your level of health and the timing of your surgery.
Your health care provider may recommend that you delay any additional elective dental work for at least six months after your surgery. If there’s an urgent need for dental work, ask your doctor if preventive antibiotics are needed. (adapted from Mayo Clinic Health Letter) — Dr. Daniel DeSimone, Infectious Diseases, Mayo Clinic, Rochester, Minnesota