Table 3.112.

Key considerations for dental management in mitral valve disease (see text)

	Management modifications*	Comments/possible complications
Risk assessment	2	Infective endocarditis
Appropriate dental care	2	Ideally before any planned cardiac surgery; delay 6 months after surgery; antibiotic prophylaxis
Pain and anxiety control
– Local anaesthesia	1	Aspirating syringe; minimise epinephrine use
– Conscious sedation	3/4
– General anaesthesia	3/4
Patient access and positioning
– Access to dental office	0
– Timing of treatment	0
– Patient positioning	0
Treatment modification
– Oral surgery	1
– Implantology	1
– Conservative/Endodontics	0
– Fixed prosthetics	0
– Removable prosthetics	0
– Non-surgical periodontology	1
– Surgical periodontology	1
Hazardous and contraindicated drugs	2	Some patients are treated with anticoagulants

^*0 = No special considerations. 1 = Caution advised. 2 = Specialised medical advice recommended in some cases. 3 = Specialised medical advice mandatory. 4 = Only to be performed in hospital environment. 5 = Should be avoided.