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Medical Emergencies · single question

A patient is scheduled for cardiac surgery (valve replacement) in two weeks. What is the MOST appropriate dental management?

  1. Complete necessary treatment, including extraction of hopeless teeth, before the surgery
  2. Take radiographs only and place the patient on antibiotics
  3. Defer all dental treatment until at least 6 months after the surgery
  4. Provide prophylaxis only and re-evaluate in one year
Show answer and explanation

Correct answer: A. Complete necessary treatment, including extraction of hopeless teeth, before the surgery

  • A. Correct. Patients awaiting cardiac valve surgery should be dentally cleared BEFOREHAND: eliminate active infection, extract non-restorable/hopeless teeth, and complete needed periodontal and restorative care, ideally allowing time for healing before the operation. Once a prosthetic valve is in place, the patient carries lifelong endocarditis risk and any invasive care becomes higher-stakes.
  • B. Antibiotics do not eliminate a source of infection such as a hopeless tooth or a periapical abscess; definitive treatment is required.
  • C. Waiting 6 months post-operatively is the guidance after a myocardial infarction for ELECTIVE care — it is the opposite of what is needed here, where the goal is to remove infectious risk before the valve is implanted.
  • D. Prophylaxis alone leaves active dental infection in place at the time of surgery, risking early prosthetic valve endocarditis.

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