Oral hygiene helps prevent heart disease
Despite appearing distant, mouth and heart are well connected, especially for those who have a heart problem. The reason is bacteria that cause gingival diseases (gingivitis and periodontitis), which are also responsible for endocarditis - an infection in the inner tissue of the heart, the endocardium.
The vehicle of bacteria from the mouth to the heart is blood, and the oral hygiene is able to prevent this process from starting. "The most common is that bacteria get into the bloodstream because of bad hygiene of the teeth and mouth. They take advantage of small gum wounds to go into the blood and spread through the body," says cardiologist Daniel Arkader Kopiler ( CRM-RJ 44865-8), president of the Brazilian Society of Exercise and Sports Medicine (SBMEE).
He explains that people with heart problems, such as heart valve disease or an artificial valve, are more prone to to contract endocarditis: "Bacteria find in the heart, which already has these conditions, a more propitious environment to make their colonies and develop the infection. It does not mean that those who do not have any of that are free, but they are very rare cases."
Clean mouth, distant danger
Those who are predisposed to bacterial endocarditis must therefore have impeccable oral hygiene. The dental aesthetist Marcelo Augusto Moreira (CRO-SP 43311), of the Oral Workshop, advises: "The brushing must be correct, to maintain the periodontium [set of tissues involved in the fixation of teeth to the bones] healthy and free of gingival diseases" .
Consultations with the trusted dentist, for professional cleaning, complement the care. "It's not like these patients do not visit the dentist on a regular basis, it's in the office that they can do the cleansing and scraping sessions necessary to prevent the inflammation that can lead bacteria into the bloodstream," he says. is subject to endocarditis. "Implants may suffer from peri-implantitis, which is similar to gingivitis, and patients who are totally without teeth may also have endocarditis if there are fungi on the prosthesis and they enter the bloodstream."
In the dentist's chair
In addition to precautions to prevent blood contamination by gingival bacteria, the cardiac patient should always keep the conversation with the dentist up to date on the treatments he undergoes.
"The medicines commonly used by the dentist to make a restoration or a canal treatment, for example, may alter the action of the medications taken by those with valve problems, "says cardiologist Daniel Arkader Kopiler.
It is also important that the dentist be aware of the patient's heart condition in order to be able to do a pre-procedure antibiotic prophylaxis. Marcelo says that the recommendation of the American Heart Association is to take 2g of amoxiline one hour before starting any oral work. This prevents some bleeding from opening the way for the entry of oral bacteria into the bloodstream.
Above all, the dentist must be confident to take care of the heart patient's mouth. "Ideally, he should have advanced knowledge so that the cardiac patient feels safe with this professional and does not neglect the regular cleanings that he should do," says Daniel.
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