Although not exactly an enjoyable experience that most of would look forward to, how often do you stop and wonder if it could actually be harmful to your heart, or even fatal ?
We all have many different kinds of bacteria living inside our mouths, and under normal circumstances, and with good oral hygiene these usually pose little threat to our heart, or general health. However, when we have surgical dental work done, some of these resident bacteria may find their way through the incision into the bloodstream.
Whilst this in itself it not usually a problem for most people, as the these bacteria are usually killed off by the body’s own defence system, for some it can be the trigger for a heart condition known as Endocarditis.
What is Endocarditis ?
This is an inflammatory heart condition that affects the inner lining of the heart (known as the Endocardium)
Who is at risk ?
People most at risk of developing dental related Endocarditis are those who have existing damaged or leaking heart valves. For reasons not entirely understood, the oral bacteria tend to be attracted to, and cluster around the site of the leaking or damaged valve. Other groups of high risk people are those who have previously had replacement heart valves fitted, and those with congenital heart disease.
Can the condition be fatal ?
The build up of bacteria around the heart valve can cause it to malfunction, (in addition to the infection of the Endocardium). In some cases the heart valve will actually be prevented from opening and closing properly due to the ‘crust’ of bacterial matter around the edge of the valve, and this is the most dangerous part of the condition, and it can be fatal.
Secondary bacterial infection
A secondary problem is that part of the bacterial ‘crust’ can break away from the heart valve, due to the force of the flow of blood, and travel round the body in the bloodstream. This can cause secondary infections in other organs such as the liver, kidneys and even the brain.
Precautionary measures prior to dental surgery
People in the high risk groups should already be aware (from their doctor) of the potential risk of Endocarditis. If you have any questions regarding this condition, you should always seek qualified medical advice from your doctor before you contemplate having any invasive dental work performed.
The usual medical advice for at-risk dental patients is to take anti-biotic medication approximately one hour prior to the scheduled surgery. This should kill any stray oral bacteria before they can reach a heart valve. However the United Kingdom ‘National Institute for Clinical Excellence’ (NICE) seems to cast doubt whether pre-surgery anti-biotic treatment is effective at preventing Endocarditis.
The condition is relatively rare
Although there may be a small minority of people who do not know they are in one of the ‘at-risk’ groups, this condition is relatively rare. In the united Kingdom, the number of diagnosed cases has fallen by 80% in the past 65 years, thanks largely due to improved heart related diagnostic equipment and procedures. However there are still over 200 deaths each year in the United Kingdom, so it is well worth educating yourself about the condition.