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Dean George is the Marketing Specialist and Content Creator for Dental Insurance
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Special care needed for heart patients seeking dental care

Jan 16, 2013

Heart patients need special consideration when seeking dental treatments

Photo Source: Des Moines University
 
Two months ago we posted a Dental Wire article disputing the conventional wisdom of having heart patients delay dental treatment from 30 days to six months after a heart procedure.

The report on which the article was based claimed that there was a minimal risk of a second vascular event when getting dental treatment, although more invasive procedures should be evaluated on an individual basis depending on urgency. The 2012 report was based on a University of Minnesota study and published in The Journal of the American Dental Association.

Ronald Reagan once told Mikhail Gorbachev in describing the importance of transparency, “Trust but verify.” No offense to the University of Minnesota but we decided to trust and verify their reported findings with a cardiologist acquaintance in Columbus, Indiana.

Dr John Fry specializes in coronary angioplasty, stent implementation and internal medicine at Vascular Partners with his partner, Dr. Matt French.

After reviewing the article and the study, Dr. Fry was kind enough to offer his professional opinion in an emailed reply.  His comments are worth sharing with Agent Straight-Talk blog readers who may be heart patients or know someone who is.  

“The study is a very general overview and we do not have specifics regarding the cardiovascular management of these patients prior to the procedure,” Dr. Fry cautioned. “Nonetheless it is an interesting study in that actual dental procedures themselves appear to be safe in the six months following a cardiovascular event.”

Because Dr. Fry specializes in stents for his patients, he quickly zeroed in on that aspect of the study.

“Stent patients are treated with many important medications after getting a heart stent. Some of these are blood thinners that prevent clotting in the stent while it heals properly over the period of about a year,” he explained.

Dr. Fry noted that one concern with the study findings is the admission that many dentists, due to health concerns about their patients bleeding during a procedure, request patients stop blood thinning medications prior to an invasive treatment like a root canal or tooth extraction.

Dr. Fry explained why this was a concern for many cardiologists.

“Many dental providers request that these medications be stopped but abrupt discontinuation of these medicines can lead to catastrophic stent clotting, heart attack, and even death,” Dr. Fry wrote.  “That’s why many cardiology organizations recommend uninterrupted continuation of these medications for at least one year, except for extreme circumstances.”

Continuing, he said, “Many patients require various non-heart related medical and dental procedures in the year following receiving a heart stent. But we recommend that these procedures be postponed as much as possible for the year following treatment."

“For those (dental) procedures that are necessary or urgent, we favor the continuation of blood thinning agents if possible.”

As for those dentists concerned about patient bleeding, Dr. Fry had this to say.

“Studies have shown that for minor surgeries or most dental procedures, continuation of blood thinners by dental patients does not increase the risk of major bleeding. Minor or nuisance bleeding should be expected but can be easily managed,” he said.

“If blood thinners must be stopped due to potential bleeding issues with a given procedure, that may be done with the understanding that there is some risk to doing so and that the blood thinning medications should be resumed as soon as possible.”

Dr. Fry had this advice for any heart patient needing dental treatment within a year of receiving a heart procedure.  “Although many dental procedures are not associated with any increased risk, many patients with a recent vascular event require careful preparation and medications management prior to a procedure.”

Bottom line: “Those patients with a recent vascular event should consult with a cardiovascular specialist prior to any non-cardiac or dental procedure to help plan for the safest outcome."

You heard the man.  Doctor's orders.

Agent Straight-Talk wants to thank Dr. Fry for taking time to review the earlier post and comment on the 2012 study. The more information bio-science, medicine and technology reveal and make possible, the more critical it is health professionals communicate with each other and those of us undergoing treatment communicate with them.

Thanks for reading Agent Straight-Talk, and remember: A smile is the light in the window of your face that tells people you are at home.

Email me at: AgentStraightTalk@DentalInsuranceStore.com

Copyright 2013, Bloom Insurance Agency, LLC©

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