A patient is referred to the dental clinic 2 weeks before scheduled heart surgery and is found to need both restorations and extractions. What is the most appropriate treatment plan?

When a patient is referred before cardiac surgery (such as valve replacement), all necessary dental treatment should be completed before the surgery if time permits. Active dental infection (from carious teeth requiring extraction or restorations) poses a risk of bacteremia that could seed cardiac valves or prosthetic material during or after surgery. Completing all extractions and restorations at least 10 to 14 days before surgery allows adequate healing time and reduces post-surgical infection risk. Deferring treatment until after cardiac surgery increases the risk of infection complications during the post-operative period when the patient may be immunocompromised or on anticoagulants.