A pre-cardiac surgery patient (2 weeks before surgery) has Stage IV periodontitis with multiple hopeless teeth and heavy calculus buildup. What is the MOST appropriate dental treatment?

Correct answer: C. Both SRP and extraction of hopeless teeth before surgery (eliminate ALL sources of oral infection)

• A. Deferring all treatment risks post-surgical endocarditis from untreated oral infection — this is the WRONG approach.
• B. Leaving active periodontal disease (only doing extractions, no SRP) is equally inadequate — active infection remains.
• C. Correct. Before cardiac surgery, ALL sources of dental infection must be eliminated to prevent bacteremia from traveling to the surgical site (valve, graft) and causing infective endocarditis — a potentially fatal complication. This means performing BOTH SRP (to treat periodontal infection) AND extraction of periodontally hopeless teeth BEFORE the surgery. Leaving any source of infection is contraindicated.
• D. Leaving hopeless teeth (ongoing infection) while doing only SRP is insufficient — untreated infection can still seed the surgical site.