The Value of Optimizing Dentition Before Cardiac Surgery

A P y PATIENT’S TEETH and intraoral tissues are not an anesthesiologist’s primary concern before a cardiothoracic rocedure. However, the potentially deleterious effects of an ntreated oral infection can have wide-reaching implications.1,2 ecognizing this hazard preoperatively is paramount in order to aximize the overall benefit of the procedure.3-5 This review laborates on the association between oral health and cardioascular disease (CVD) by presenting the rationale for optiizing dentition before cardiac surgery, and reviews the unerstated role that an anesthesiologist may play in this scenario. The patient’s airway has long been the principal focus for the nesthesiologist. Appropriately, an evaluation of the various redictors of a potentially difficult endotracheal intubation ocurs during the preoperative patient assessment. This assessent usually includes a very cursory examination of the paient’s dentition or lack thereof. Such an examination is often irected toward the presence of any loose or chipped teeth, any xed or removable prosthetic dental appliances, and the meaurement of the width in finger breadths with respect to a atient’s maximal interincisal distance. Determining the suseptibility of any loose teeth and taking appropriate precautions o avoid dental damage in the perioperative period are necesary, yet are not necessarily enough. Preoperatively, the aneshesiologist’s attention should extend beyond noting which eeth are vulnerable to a traumatic intubation and include a ore thorough evaluation of the overall condition of the paient’s dentition.